#177 The 6 Things That Put You in a Nursing Home

The 6 Things That Put You in a Nursing Home

No one wants to end their life in a nursing home.  In this article, I share the 6 things that could put you in a nursing home and what you can do now to avoid this fate.

Brian’s Experience

For years, I cared for Brian as his cardiologist.  Each time he came to see me, he was always excited to share their latest travel plans once he retired.

Tragically, two weeks after he retired, he suffered a massive stroke.  Their travel plans were forever changed.

His stroke left him so weak on the left side of his body that he could no longer get to the bathroom or dress himself independently.  As he was a big person, his wife was physically unable to lift or help him.

Brian’s wife tried everything possible to keep him in the home.  She arranged for neighbors and family members to help her bathe and dress him.  However, in the end, it was too much.  Both of them realized that a nursing home was their only option.

On one of our clinic visits Brian said, “if I knew my life was going to end this way I would have taken better care of myself.”  Sadly, this is something that I often hear from patients.

The 6 Things That Put You in a Nursing Home Study

In an interesting study, researchers from Rutgers University in New Jersey studied 4,254 people to find out what eventually put them in a nursing home.  Starting at age 45, they followed these people for 21 years.

Below are the six top causes that led middle aged people to ultimately require a nursing home.  As you might suspect, the more of these six factors people had, the higher their risk.

1. Diabetes: 325% Increased Risk

Based on the results of this study, diabetes was the number one thing that could put you in a nursing home.  This finding may come as a surprise for many, as diabetes is so common.

The word, diabetes mellitus, actually means “like honey” in Greek.  This is because ancient physicians tasted the urine of their patients.  These ancient physicians noticed that the urine of diabetics tasted like honey.

Glucose, or sugar, is not only high in the urine with diabetes.  It is also elevated in the blood as well.

The elevated levels of glucose in the blood then wears out the arteries, heart, kidney, and brain.  Over time, people suffering from diabetes are prone to heart attacks, atrial fibrillation, strokes, kidney failure, dementia, and other conditions.

If you have diabetes, what can you do now?

As diabetes is defined as a hemoglobin A1C blood test measurement of 6.5 or higher, the goal is to get your hemoglobin A1C below the diabetes range.  The hemoglobin A1C measures how much glucose is coating your red blood cells.  As red blood cells live an average of three months, the hemoglobin A1C gives you a running three month average of how high your blood glucose has been.

Fortunately, most people can get their hemoglobin A1C below the diabetes zone with simple lifestyle changes.  Indeed, most of my patients can get their hemoglobin A1C below 6.5 with daily exercise, healthy eating (avoiding processed carbohydrates), and getting back to a healthy weight.

In some cases, medications may be required.  Also, even those suffering from the genetic causes of diabetes can minimize the insulin they need with healthy lifestyle changes.

2. Smoking: 56% Increased Risk

Personally, I would have predicted smoking to be at least on par with diabetes.  Perhaps the reason why smoking did not come in at number one is because smokers may not live long enough to need a nursing home.

As everyone is familiar with the risks of smoking, I won’t go into it here.  If you are still smoking, now is the time to quit. Get help, as this addiction can be beaten with the right tools!

3. Inactivity: 40% Increased Risk

Inactivity, or not exercising daily, came in as the third leading reason of why middle aged people ultimately end their lives in a nursing home.  This is another risk factor that can be easily reversed.

Unfortunately, your muscles start to atrophy (weaken) quickly after age 40 if you aren’t exercising.  Exercise is not a choice.  It is a requirement for good health.

4. Obesity: 35% Increased Risk

Obesity was the number four thing from this study that could put you in a nursing home.  In this study, obesity was defined as a BMI of 30 or higher.  To find out your BMI, click here.

If your BMI is above 30, it is imperative that you get it down to the healthy range as soon as possible.  While diets don’t work long-term, lifestyle changes do.

By simply doing four things, most of my patients can maintain a healthy weight.  Avoid processed carbs, exercise daily, sleep at night, and keep unhealthy stress levels in check.

5. Systolic Blood Pressure Above 140 mmHg: 35% Increased Risk

The systolic blood pressure number is the top number you see when taking your blood pressure.  Ideally, your resting blood pressure should never be above 120/80 mmHg.

The reason why high blood pressure could put you in a nursing home is that high blood pressure wears out your heart, brain, and kidneys.  As with diabetes, high blood pressure causes heart attacks, heart failure, atrial fibrillation, strokes, kidney failure, dementia, etc.

Fortunately, most people can get their blood pressure back to the normal with simple lifestyle changes.  To learn more about how to lower your blood pressure naturally, please read the article I wrote called, The Top 10 Ways to Lower Blood Pressure Naturally (blog 131).

Of course, if your doctor has already prescribed a blood pressure lowering medication, don’t stop it on your own.  Work with your doctor to get off this medication over time as you adopt a healthier lifestyle.

6. Total Cholesterol Above 240 mg/dL: 14% Increased Risk

Lastly, a total cholesterol of 240 mg/dL or higher came in as the sixth leading cause of middle aged people ending up in a nursing home.  For those of you outside of the U.S., this is a total cholesterol of 6.2 mmol/L or higher.

If your total cholesterol is high, does that mean you need to take a statin cholesterol lowering drug for the rest of your life?  Fortunately, you probably don’t need a statin with the right lifestyle changes.

To learn how to lower your cholesterol naturally, please read the article I wrote called, Five Ways to Lower Your Cholesterol Without Medications (blog 9).  As with blood pressure medications, if your doctor has prescribed cholesterol lowering medications, don’t stop them on your own.  Work with your doctor to get off this medication over time with a healthy lifestyle.

Take Home Message

Independence is the key to successful and happy aging.  Fortunately, studies show that most people can live to age 90 in good health with a healthy lifestyle.

The key is to adopt a healthy lifestyle now.

What are you doing to reverse these six risk factors that could put you in a nursing home?  Please leave your comments and questions below.

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  1. Thank you a lot. How can I get a copy of this to send to a dear friend who does not have a computer? I really want to help her but she does not have a computer. Please tell me.

    • Hi Glenda,

      Thank you so much for your desire to share this newsletter. As I write and prepare every newsletter myself, I am unable to do anything more than provide a free electronic copy at this time. Perhaps there is a family member who would be willing to print it out for her?



  2. Thank you for sharing. I have been trying to tell my aunt to stay more active. I can see that she has an increased chance of ending up in a nursing home. I will share this with her and see what she thinks.

  3. I love this article. I am a Social Worker with the Elderly and disabled population. Every time I go to the Nursing Home, I think….what can I do now so that I don’t end up here later. It’s something we all need to think about while we can still make changes.
    Thank You!

  4. Terri Barton suggested I sign up with your messages. I have had diabetes for about 35 years and am now trying to follow Dr. Jason Fung a nephrologist in Toronto. His belief is that excess insulin leads to fatty liver, pancreas etc and once the pancreas is too fat it does not produce enough insulin to regulate the blood sugar. To get over the diabetes, one should fast for two for three days at one time or longer if you can do it and only drink water, sugar free coffee, tea etc. Once your glucose is not taking care of your energy needs, the body uses the fats in your liver to generate energy from ketone bodies. Your ketone bodies will increase in the blood and he doesn’t recommend that they do not go over 6.5 mM. by fasting two times a week you will at first get hungry but if you persist the hunger pangs go away. I have found that I can go for three days and then eat a low carb diet and go back. After a few weeks I measured my C peptide indicating that my insulin was coming back. However, I haven’t persisted long enough to lose my liver fat and all my pancreas fat. I lost 30 pounds doing this and an inch or two off my waste. My belt size was 40 inches to start with. I am seeing a endocrinologist every three months to monitor my progress. Dr. Fung has a patient who has gotten over her diabetes through his program and conducts video sessions with patients who cannot go to Toronto. We video discuss our progress every two or three weeks. Once our own insulin takes care of our needs we are still at risk and we must follow a low carbohydrate high fat diet. Now I have a harder time to stay on the diet because I am the sole cook in the house because of my wife’s dementia that I am having to take care of which I am happy to be able to do it. For medication I take Toujeo about 10 to 14 units before going to bed. When I had an insulin pump I would use 25 to 35 units of insulin a day. My A1C had been 8.9 and has dropped a little to 7.9. I hope the next time it will be below 7.0. I was touched by your hunger advice but I really think Dr. Fung has something. He hot on to this because of the high number of patients were strikingly obese, some of whom were diabetic.

    • Hi LaVell,

      Thanks for reaching out. There is definitely some fascinating research coming from intermittent fasting not only with diabetes and weight loss but also with longevity and other health markers.

      If you want to learn more, here is an article I wrote on intermittent fasting: https://drjohnday.com/intermittent-fasting-weight-loss-longevity/

      Congratulations on lowering your hemoglobin A1C! You will soon be below the diabetes level of 6.5!