Aging in place through home-based care is a leading outcome for seniors

Didier Malagies • January 31, 2024


While individual needs and health issues will primarily dictate how a person spends their final years, a new study shows that home-based care is a leading outcome for older Americans. This conclusion comes from a new study by researchers at Rutgers University in New Jersey. Hospice News first reported the findings.

“The aim of this study was to determine the trajectories for place of care in each quarter during the last three years of life among Medicare beneficiaries and the factors associated with these trajectories,” the researchers explained. “A retrospective cohort was assembled from Medicare beneficiaries who died in 2018, and a 10% random sample of the cohort was analyzed.”


The final results were ultimately sorted into three predominant “clusters,” they explained, including home care, skilled home care and institutional care. The far-and-away preference for the sample was in some type of home-based care, according to the findings.


“Nationally, over half (59%) of Medicare beneficiaries were in the home cluster, one-quarter (27%) were in the skilled home care cluster, and the rest (14%) were in the institutional cluster,” the researchers said. “There were large variations by state in the use of services during the last three years of life.”

Home care without a skilled nursing element was most frequent among Medicare beneficiaries in Alaska (81.5%), Puerto Rico (81.4%), Hawaii (72.9%), Arizona (69.2%) and Oregon (68.9%). They were least frequent among beneficiaries from Massachusetts (47.1%), Louisiana (47.8%), Rhode Island (48.3%), and Connecticut (48.6%).


“Our findings are similar to those reported in a recent prospective cohort study using a representative sample from the National Health and Aging Trends Study (NHATS), which also found that 58% of NHATS participants remained at home and 17% transitioned to or died in an institutional setting,” the Rutgers study found. “Our findings are also consistent with the recent downward trend of deaths in acute care hospitals and upward trend of deaths in home and community settings.”


Still, while the primary preference appears to be aging at home, more information is required to fully understand these preferences, the researchers concluded.


“While the majority of older adults spent their final years at home with minimal use of skilled home care or institutional care until the final months of life, 40% had major health service needs,” they said. “Extended use of skilled home care or institutional care was more frequent among older adults living with multiple chronic conditions, including dementia.”


Future research that aims to understand “the health care systems and policy factors that influence place of care trajectories” could help advance refinement of the care experience, health of the population and associated care costs, they added.


Aging-in-place preferences among older Americans are well documented, and the drivers of these preferences have also been subjects of recent discussion. Long-term care is also an increasingly large priority for older Americans.



The reverse mortgage industry often aims to position its product offerings as conducive to the goals of aging in place. The results of the Rutgers study may shed light on the broader considerations that lead older Americans to seek out certain end-of-life care paths, particularly as the U.S. population grows older more quickly.









Have A Question?

Use the form below and we will give your our expert answers!

Reverse Mortgage Ask A Question


Start Your Loan with DDA today
Your local Mortgage Broker

Mortgage Broker Largo
See our Reviews

Looking for more details? Listen to our extended podcast! 

Check out our other helpful videos to learn more about credit and residential mortgages.

By Didier Malagies July 28, 2025
When the 10-year Treasury yield goes down, it generally signals lower interest rates and increased demand for safe-haven assets like U.S. government bonds. Here’s what typically happens across different areas of the economy and markets: 🔻 Why the 10-Year Treasury Yield Drops Increased demand for bonds: Investors buy Treasuries during uncertain times (e.g., recession fears, geopolitical risk), which drives prices up and yields down. Expectations of lower inflation or interest rates: If the Federal Reserve is expected to cut rates or inflation is cooling, yields tend to fall. Weak economic outlook: Slowing growth or a poor jobs report can trigger a yield decline. 📉 Impacts of a Lower 10-Year Treasury Yield 🏦 1. Mortgage Rates and Loans Mortgage rates (especially 30-year fixed) tend to follow the 10-year Treasury. As yields fall, mortgage rates usually decline, making home loans cheaper. This can stimulate the housing market and refinancing activity. 📈 2. Stock Market Lower yields often boost stock prices, especially growth stocks (like tech), because: Borrowing costs are lower. Future earnings are worth more when discounted at a lower rate. Defensive and interest-sensitive sectors (like utilities and real estate) also benefit. 💰 3. Consumer and Business Borrowing Lower Treasury yields can lead to lower interest rates across the board, including for: Auto loans Credit cards Business loans This can boost consumer spending and business investment. 💵 4. U.S. Dollar Falling yields can make U.S. assets less attractive to foreign investors. This can weaken the dollar, which may help U.S. exporters by making goods cheaper abroad. 🪙 5. Inflation Expectations If the yield is falling due to low inflation expectations, it may indicate deflationary pressure. However, if it's just due to safe-haven buying, it might not reflect inflation at all. ⚠️ Potential Risks A sharp drop in the 10-year yield can signal a recession or loss of confidence in the economy. A flattening or inverted yield curve (when short-term rates are higher than long-term) can be a recession warning. tune in and learn https://www.ddamortgage.com/blog didier malagies nmls#212566 dda mortgage nmls#324329
By Didier Malagies July 21, 2025
Resi/commercial Typical 2-3 units over a 1-unit ground-floor commercial space LTV’s up to 75% A mixed-use property is a type of real estate development that combines two or more different uses within a single building or development. The most common combination is residential and commercial — for example, apartments or condos above ground-floor retail or office space. 🔑 Key Characteristics of a Mixed-Use Property: Feature Description Use Types Typically includes residential, commercial, retail, office, and sometimes hospitality or industrial components. Zoning Must be zoned for mixed-use by the local municipality. Layout Different uses are separated vertically (e.g., retail on the bottom, housing on top) or horizontally (different sections of the development). Ownership Can be owned by an individual, company, REIT, or government entity; may be leased or sold as separate units. Financing Considered commercial real estate; underwriting depends on the income mix and proportions of use types. 🏢 Common Mixed-Use Examples: Urban Buildings: Apartments above restaurants or retail stores (like Starbucks or a dry cleaner). Suburban Developments: Townhome communities built around a retail plaza or office park. Live/Work Units: Ground-floor office or retail space with a residence above, often used by entrepreneurs. Transit-Oriented Developments: Mixed-use buildings near train stations or bus hubs. 📊 Benefits of Mixed-Use Properties: Diversified Income Streams (residential + commercial) Increased Foot Traffic for businesses Live-Work-Play Environment appeals to urban dwellers Higher Land Use Efficiency and potentially better returns Encouraged by city planning to reduce sprawl and support sustainability A mixed-use property is a type of real estate development that combines two or more different uses within a single building or development. The most common combination is residential and commercial — for example, apartments or condos above ground-floor retail or office space. 🔑 Key Characteristics of a Mixed-Use Property: Feature Description Use Types Typically includes residential, commercial, retail, office, and sometimes hospitality or industrial components. Zoning Must be zoned for mixed-use by the local municipality. Layout Different uses are separated vertically (e.g., retail on bottom, housing on top) or horizontally (different sections of the development). Ownership Can be owned by an individual, company, REIT, or government entity; may be leased or sold as separate units. Financing Considered commercial real estate; underwriting depends on the income mix and proportions of use types. 🏢 Common Mixed-Use Examples: Urban Buildings: Apartments above restaurants or retail stores (like Starbucks or a dry cleaner). Suburban Developments: Townhome communities built around a retail plaza or office park. Live/Work Units: Ground-floor office or retail space with a residence above, often used by entrepreneurs. Transit-Oriented Developments: Mixed-use buildings near train stations or bus hubs. 📊 Benefits of Mixed-Use Properties: Diversified Income Streams (residential + commercial) Increased Foot Traffic for businesses Live-Work-Play Environment appeals to urban dwellers Higher Land Use Efficiency and potentially better returns Encouraged by city planning to reduce sprawl and support sustainability and 🔑 Key Characteristics of 5–10 Unit Multifamily Properties: Feature Description Number of Units 5 to 10 self-contained rental units, each with a kitchen and bathroom. Zoning Generally zoned as multifamily residential or mixed-use, depending on the area. Financing Category Considered commercial real estate by most lenders (5+ units triggers commercial underwriting). Ownership Typically owned by small investors, partnerships, or LLCs. Management Can be owner-managed or managed by a third-party property manager. 4. Private or Bridge Loans Short-term, higher interest Used for rehabs, quick purchases, or properties that don’t qualify for traditional financing 📊 Why Investors Like 5–10 Unit Multifamily: Easier to manage than large apartment complexes More scalable than single-family rentals Still eligible for economies of scale (one roof, one lawn, multiple rents) Can often house hack (live in one unit, rent the others) Tune in and learn https://www.ddamortgage.com/blog didier malagies nmls#212566 dda mortgage nmls#324329
By Didier Malagies July 14, 2025
📉 1. Borrowing Becomes Cheaper Mortgage rates tend to fall, making it easier for people to buy homes or refinance. Car loans, personal loans, and credit cards may also have lower interest rates. Businesses can borrow more cheaply to invest in growth. 💸 2. Consumer Spending Increases Since borrowing is cheaper and savings earn less interest, people are more likely to spend money rather than save it. This can boost demand for goods and services, helping to stimulate economic activity. 🏦 3. Savings Yield Less Savings accounts, CDs, and bonds typically offer lower returns. This can push investors to move money into riskier assets like stocks or real estate in search of higher returns. 📈 4. Stock Market Often Rallies Lower rates can mean higher corporate profits (due to cheaper debt) and increased consumer spending. Investors may shift funds from bonds into stocks, driving up equity prices. 💵 5. The U.S. Dollar May Weaken Lower interest rates can make the dollar less attractive to foreign investors, potentially weakening the currency. This can help U.S. exporters (as their goods become cheaper abroad) but may also increase the cost of imports. 🧩 6. Inflation Could Rise More spending and borrowing can increase demand, which may push prices up, leading to higher inflation—especially if supply can’t keep up. 🏚️ 7. Real Estate Activity Tends to Pick Up Lower mortgage rates can boost homebuying, refinancing, and construction, which helps stimulate related industries. tune in and learn https://www.ddamortgage.com/blog didier malagies nmls#212566 dda mortgage nmls#324329 
Show More