It's no longer unusual to find a nursing home resident who is decades younger than his neighbor: About one in seven people now living in such facilities in the U.S. is under 65. But the growing phenomenon presents a host of challenges for nursing homes, while patients like Martin face staggering isolation.
"It's just a depressing place to live," Martin says. "I'm stuck here. You don't have no privacy at all. People die around you all the time. It starts to really get depressing because all you're seeing is negative, negative, negative."
The number of under-65 nursing home residents has risen about 22 percent in the past eight years to about 203,000, according to an analysis of statistics from the Centers for Medicare and Medicaid Services. That number has climbed as mental health facilities close and medical advances keep people alive after they've suffered traumatic injuries. Still, the overall percentage of nursing home residents 30 and younger is less than 1 percent.
Martin was left a quadriplegic when he was accidentally shot in the neck last year by his stepbrother. He spent weeks hospitalized before being released to a different nursing home and eventually ended up in his current residence, the Sarasota Health and Rehabilitation Center. There are other residents who are well short of retirement age, but he is the youngest.
The yellow calendar on the wall of Martin's small end-of-the-hall room advertises activities such as arts and crafts. In the small common room down the hall, a worker draws a bingo ball and intones, "I-16. I-one-six." As Martin maneuvers his motorized wheelchair through the hallway, most of those he passes have white hair and wrinkled skin.
"It's lonely here," Martin says, as a single tear drips from his right eye.
Martin exchanges muted hellos with older residents as he travels down the hall to smoke outside. His entire daily routine, from showering to eating to enjoying a cigarette, is dictated by the schedules of those on whom he relies for help.
He usually wakes up late, then waits for an aide to shower him, dress him and return him to his wheelchair. He watches TV, goes to therapy five days a week and waits most days for his friend to bring him meals.
He mostly keeps to himself, engaging in infrequent and superficial conversations with his elders.
Martin's parents are unable to care for him at home. His father is a truck driver who is constantly on the road, and his stepmother is sick with lupus. Medicaid pays his bills; it could take a lawsuit for him to get care outside a nursing home.
Advocates who help young patients find alternatives to nursing homes say people are often surprised to learn there are so many in the facilities. About 15 percent of nursing home residents are under 65.
"When I tell people I try to get kids out of nursing homes, they have no idea," says Katie Chandler, a social worker for the nonprofit Georgia Advocacy Office.
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