Over Half of Caregivers Provide Full-Time Support During the Waiting Period — Insights from 586 Individuals and Families with Experience in Special Nursing Home Admissions

Special Nursing Homes (SNFs) serve as a last resort for families, providing long-term public care support for elderly individuals requiring assistance. However, these are not facilities where one can move in immediately upon application; instead, there is typically a "waiting period" ranging from several months to several years before admission. During this time, what kind of living conditions do care recipients and their families face, and how do they continue caregiving? Despite ongoing policy discussions, the real-life experiences of those involved have not been sufficiently visualized.

To address this, Speee Inc. (Headquarters: Minato-ku, Tokyo; CEO: Hideki Otsuka; TSE Standard: 4499), operator of the care facility review platform "CareSuru Kaigo," conducted a screening survey of 1,000 individuals nationwide. From this group, they deeply interviewed 586 individuals and family members who had experience applying for or residing in SNFs, gathering detailed data on the number of facilities applied to, waiting times, changes in care levels, living conditions during the waiting period, and caregiver circumstances. This press release presents five key insights into the realities families face while "waiting their turn."

【Survey Summary】

Length of waiting period: 42.1% of households experienced a waiting period of "six months or more" before SNF admission, and 22.9% waited "over one year," indicating that the process from application to admission is far from short.

Multiple applications have become standard: 61.8% applied to two or more SNFs, showing that parallel applications to multiple facilities have become a de facto standard.

14.2% of households applied to four or more facilities.

Approximately 40% applied under exceptions or early admission: While SNF admission原则上 requires a care level of 3 or higher, about 40% of cases achieved admission at a lower care level. This reveals real-world practices such as exception-based admissions due to dementia or family employment situations, as well as early consultation behaviors.

Waiting while living alone or at home: During the waiting period, 66.0% of applicants lived alone, and 64.2% were in a "home care" situation. The reality is that families continue caregiving at home until a facility spot becomes available.

Caregiver employment status: At the time of admission, 52.2% of caregivers were "working full-time," and 22.0% reported "no one else available to help with caregiving." Amid the pressure to balance work and caregiving, 12.8% had considered or actually left or changed jobs.

Topic 1: Waiting Period for SNF Admission — Over 40% Wait More Than Six Months, Over 20% Wait Over a Year

When asked about the waiting period from application to admission, 16.5% waited "less than one month," and 24.4% waited "1 to less than 3 months," indicating some families were admitted quickly. However, 19.3% waited "6 to less than 12 months," 10.9% waited "1 to less than 2 years," 6.5% waited "2 to less than 3 years," and 5.5% waited "3 years or more." Thus, 42.1% waited six months or more, and 22.9% waited over a year.

The difficulty of gaining admission to SNFs and the length of waiting periods have long been recognized as social issues. The data from 586 respondents reaffirms these realities with concrete figures.

Prolonged waiting periods not only risk worsening the care recipient’s condition but also significantly impact family members’ life planning and ability to maintain employment over the long term.

[Figure 1] Waiting Period Until SNF Admission (n=586)

Period

Percentage

Less than 1 month

16.55%

1 to less than 3 months

24.40%

3 to less than 6 months

16.89%

6 to less than 12 months

19.28%

1 to less than 2 years

10.92%

2 to less than 3 years

6.48%

3 years or more

5.46%

Waiting 6+ months: 42.1% / Waiting 1+ year: 22.9%

Topic 2: Application Behavior — Over 60% Apply to Multiple Facilities in Parallel

The number of SNFs applied to was "one facility" for 38.2% of respondents, "two facilities" for 27.5%, "three facilities" for 20.1%, "four facilities" for 6.1%, "five facilities" for 2.9%, and "six or more facilities" for 5.1%. Thus, 61.8% applied to two or more facilities, and 14.2% applied to four or more.

The data suggests that applying to multiple facilities in parallel is no longer an individual strategy but a standard practice adopted by many families to secure an SNF placement. For families, this involves a cumulative burden of preparing application documents, gathering information, and visiting facilities, making the "family-side workload" before admission non-negligible.

[Figure 2] Number of SNFs Applied To (n=586)

Number of Facilities

Percentage

One facility

38.23%

Two facilities

27.47%

Three facilities

20.14%

Four facilities

6.14%

Five facilities

2.90%

Six or more facilities

5.12%

Applied to 2+ facilities: 61.8% / Applied to 4+ facilities: 14.2%

Topic 3: Care Level at Application and Admission — About 40% at Level 2 or Below

At the time of application, 24.4% were at care level 3, 21.8% at level 4, and 16.0% at level 5, totaling 62.3% at care level 3 or above. Conversely, those at care level 2 or below accounted for approximately 40% of the total.

While SNFs原则上 admit only those at care level 3 or higher, this survey found that about 30% of households had data indicating application or admission at levels such as "care level 1–2" or "support needed." This likely reflects the use of "exception-based admission" mechanisms allowed due to dementia symptoms or family employment situations, temporary improvements or changes in care level during the waiting period, or early consultation due to the limits of home care.

*Note: The figures for "independent" and "support needed" in Figure 3 may include subjective responses based on memory or confusion with experiences such as short-stay services at affiliated facilities.

[Figure 3] Care Level at Application and Admission (n=586)

Care Level

At Application

At Admission

Support Needed 1

5.46%

5.12%

Support Needed 2

6.48%

6.31%

Care Level 1

7.00%

9.39%

Care Level 2

15.70%

15.36%

Care Level 3

24.40%

26.62%

Care Level 4

21.84%

20.82%

Care Level 5

16.04%

13.14%

Care Level 3 and above: 62.3% at application / 60.6% at admission

Topic 4: Living Conditions During the Waiting Period — About 60% Living Alone

Regarding the living and care environment during the waiting period, 45.6% were "living alone (caregiver nearby/in the same prefecture)" and 20.5% were "living alone (caregiver far away/outside the prefecture)," totaling 66.0% living alone. 19.6% lived with a caregiver or other family members, and 14.3% were in households consisting only of elderly individuals (e.g., elderly couples caring for each other), indicating that most lived either alone or with an elderly spouse.

In terms of care services used, 48.6% were in "home care (with short-stay, day services, etc.)" and 15.5% in "home care (without short-stay, etc.)," totaling 64.2% receiving home care. Some (13.3%) were hospitalized, and 12.5% resided in other facilities such as convalescent homes, group homes, or nursing medical institutions. Nevertheless, the overall picture shows families continuing to support care at home during the "waiting" period until a facility spot opens.

[Figure 4] Living Situation During the Waiting Period