“I Wanted to Get Back Out There”: In-depth Interviews With Older Adults and Family Caregivers About Moving Out of Nursing Homes Using Medicaid’s Money Follows the Person Program and How Dementia Influences Transitions

Medicaid’s Money Follows the Person (MFP) Program enables nursing home residents to return to community living, yet people living with dementia (PLWD) less often transition to the community through MFP, for unclear reasons. To understand mechanisms underlying this disparity, we conducted in-depth interviews with 44 older adults in Connecticut eligible for MFP and 44 family caregivers (41% PLWD/PLWD family members). Desire to move, program awareness, ability to self-advocate, personal care needs, family support, housing and home and community-based services (HCBS) resources all influenced moves. PLWD less often desired to move, typically required more assistance to move, were less able to self-advocate and manage logistics, had higher personal care needs, needed more family/informal support, and had additional safety and supervision needs. Better support for PLWD is needed in transition and HCBS programs as the population grows, nursing homes beds decrease, and the desire to live in the community persists.