About 28-thousand Iowans reside in a nursing home today, and a national expert is urging state officials to find ways to help healthier residents move. Susan Reinhard, co-director of the Rutgers University Center for State Health Policy, works with states around the country on elder-care issues. “I’m not saying that nursing homes should never be one of the options, but we really do see a lot of people going into the nursing homes much sooner and at much lower levels of need than really would have to be the case if there were other options,” she says. Reinhard advocates changing state laws to make it easier for a relative or neighbor to care for an elderly person and get paid by the state to do so. In addition, she says while more assisted living centers are being built in Iowa, more are needed. Reinhard says the state needs to hire folks, though, who will help the elderly find somewhere to live outside a nursing home. Reinhard says it takes more energy to make matches for in-home care as opposed to just sending someone to a nursing home. Reinhard says at least half of the residents in a nursing home came from a hospital. Thirty percent came from another nursing home. Reinhard says a nursing home is “very appropriate” for rehab from serious illnesses or injuries, but many nursing home residents do get better and should be helped to move out. Reinhard says we tend to forget that “people do get better” and she believes there should be a new state effort to help those folks move out of the nursing home. Reinhard was in Iowa last week, speaking at an A-A-R-P forum. sponsored by the Iowa chapter of A-A-R-P, and she also made the argument in-home care and assisted living facilities provide care that’s cheaper. Reinhard says when an Iowan moves into a nursing home, it takes an average of five months for them to spend all their resources and then wind up on state-paid Medicaid. She says other services, like letting an elderly person live in a relative’s home, cost at least a third less than institutional, nursing home care. Reinhard says Iowa policymakers should let people “age in place” and find ways to help the elderly stay in their own homes as long as possible or in an assisted living setting before than making them move into a nursing. Reinhard says officials need to guard against the inclination to “over-protect” the elderly.”You’re never going to have a situation where people will never fall, for example, or never have anything happen to them. It’s just not possible on this earth to make this happen,” she says. The challenge, according to Reinhard, is to find a way to develop regulations that recognize that reality.