Carol Holland checked her hair in a hand-held mirror, draped a bag of lollipops over the side of her wheelchair and rolled out of her room to begin her daily routine of passing out candy to residents at Heritage Place, a Squirrel Hill nursing home.
"Good morning, dear," she sang out to Agnes Mondry, who lives in a room on the third floor. "I've got a sucker for you. I'll see you later, honey."
For 23 years, Holland worked at a nursing home in East Liberty. Although she appears at ease in Heritage Place, a skilled nursing facility that traditionally houses the elderly, she hardly fits in: At age 48, Holland is the youngest resident here.
"I got used to taking care of people. Never thought I'd have to be taken care of," said Holland, who came to Heritage Place in January after surgery. She is undergoing rehabilitation on her ankle.
In Pennsylvania and across the country, more younger people are ending up in nursing homes.
According to an analysis of statistics compiled by the Centers for Medicare and Medicaid Services, the percentage of under-65 residents in nursing facilities has risen steadily since 2002. That year, 11.7 percent of the nation's nursing home population was younger than 65. In 2006, the number rose to 13.6 percent, and by the end of 2010 it was 14.9 percent, the statistics show.
Cheaper than hospitals
At UPMC facilities, about 15 percent of patients at nursing homes are younger than 65, said Dr. David Nace, director of long-term care at the University of Pittsburgh's Institute on Aging. He said cost- cutting is driving the increase: Hospitals are pushing patients who require lengthy rehabilitation out of their beds and into nursing homes because it costs less.
"Nursing facilities today are the hospitals of the '80s," Nace said. "Everybody is trying to get people out of hospitals quicker now. It's just cheaper."
As a result, nursing homes that once catered almost exclusively to the elderly must handle a wider range of ages and illnesses, Nace said. And with more young people in the facilities, the unlikely mix of generations can result in an uneasy atmosphere -- for residents and staff.
"It's unfortunate," said Chris Moregart, 64, director of nursing at Heritage Place. "Before, nursing facilities were just all elderly people. ... It's scary when you see people younger than you having to be in a nursing home."
Most under-65 residents end up in nursing homes for rehabilitative stays generally lasting six months or shorter, Nace said. Other younger residents -- including those suffering from head trauma or other serious, long-term afflictions -- must stay longer. Only in rare cases, such as early onset dementia, do under-65 residents stay permanently, officials said.
Holland, whose rehab could take a year or longer, said she'd prefer to be home, caring for her mother and living independently, but she doesn't mind being the youngest resident at a place where she can visit with other patients and gossip with staffers.
Others do not adjust so well.
Many under-65 residents isolate themselves, staffers said. They struggle with depression. The younger the patient, the more difficult the adjustment.
Christa Magnus, director of activities at Heritage Place, said younger residents tend to keep to their rooms or hang out with other younger residents in lounges or on patios. …