Nearly 1 million Americans who turned 65 last year are likely to live in nursing homes before they die, and almost 200,000 will spend more than five years there, according to a study released Thursday.

"Over a lifetime, the risk of entering a nursing home and spending a long time there is substantial," researchers wrote.The study projects that of 2.2 million Americans who turned 65 last year, more than 900,000 of them - or 43 percent - are expected to enter a nursing home at least once before they die.

In their analysis of the findings, the researchers questioned whether nursing homes, which now cost an average of about $25,000 a year, should remain the mainstay of care for the elderly.

"When one in seven men and one in three women who reached the age of 65 in 1990 are projected to spend at least one year in a nursing home, society needs to undertake a fundamental reassessment of long-term care, rather than simply paying for what has been done in the past," they wrote.

The study was based on a survey of 16,587 adults who died in 1986. It was written by economist Peter Kemper and epidemiologist Christopher M. Murtaugh of the U.S. Agency for Health Care Policy Research in Rockville, Md., and published in the New England Journal of Medicine.

Among the findings:

- Nearly two-thirds of the people using nursing homes will be women. This is because women live longer than men, and since they outlive their spouses, there is no one at home to care for them.

- Nearly one-third of all people who reached 65 in 1990 will spend at least three months in a nursing home; 25 percent at least a year, and 9 percent at least five years.

- Thirteen percent of all women will spend at least five years in a nursing home, compared with 4 percent of men.

- In 1986, whites used nursing homes more than blacks. Even when racial differences in longevity were taken into consideration, 38 percent of whites and 27 percent of blacks lived in nursing homes before their deaths.

The number of people in U.S. nursing homes has risen dramatically in recent years. In 1964, about 500,000 people lived in nursing homes. By 1985, the number nearly tripled.


(Additional information)

As Florida's population gets older, road signs, stop lights and lane markers will get bigger.

Ben Watts, secretary of the state Department of Transportation, approved the changes Tuesday under the Older Road-User program to make driving easier for senior citizens.

The plan calls for wider stripes separating lanes, oversized road signs that are easier to read and traffic lights that are bigger and brighter.

In Florida, 17 percent of the residents were over 65 by 1980. By 2020, forecasters say, one quarter of Floridians will be in that age bracket, compared with one in six Americans nationally.

Most changes would be at or near major intersections, statistically the most likely places for accidents.