Qualitative interviews with nursing home residents and family caregivers examined why people living with dementia transition back to community living less often through Medicaid's Money Follows the Person program. Participants described strong motivation to resume community life, while cognitive impairment introduced additional complexity into planning, consent, and caregiver capacity. The work identifies modifiable barriers in a program designed to restore autonomy and community connection in later life.
Key Points
- Dementia reduces likelihood of transitioning from nursing home to community
- Interviews identify mechanisms behind unequal access to transition support
- Residents express strong motivation to resume independent community living
Longevity Analysis
Where a person lives in their final decades shapes daily movement, social contact, sleep architecture, and autonomy — all determinants of cognitive trajectory and physical resilience. Institutional settings can impose structural constraints that accelerate functional decline, while community living preserves the environmental richness and self-direction that support mental clarity and emotional stability. Identifying and removing procedural barriers to transition is a structural intervention with downstream effects on how the aging brain and body maintain capacity.
Original published by SAGE Research on Aging, by Ellis C. Dillon, Christine Bailey, Amal Alsamawi, Asmita Aasaavari, Tyfany Fabian, Julie Robison1Center on Aging, 7712University of Connecticut School of Medicine, Farmington, CT, USA2Department of Public Health Sciences, 7712University of Connecticut School of Medicine, Farmington, CT, USA3Department of Sociology, 7712University of Connecticut, Storrs, CT, USA4Department of Medicine, 21654UConn Health, Farmington, CT, USA.