While we may think of housing and senior care dwelling in distinct silos, a long-term care researcher says those should be torn down given compelling evidence on the influence of residential stability on long-term care needs. Nurse and researcher Marissa Bergh sat down with McKnight’s Long-Term Care News Senior Editor Kimberly Marselas to discuss her team’s findings, which underscore how the built environment and economic pressures often force families into making difficult nursing home placement decisions. Her review of 25 years of research suggests that for many older adults, the move to a nursing home is less a medical necessity and more a consequence of financial and physical housing failures. Bergh highlights three primary pathways through which housing impacts institutionalization: the financial asset of homeownership versus the strain of renting, the physical mismatch between declining mobility and inaccessible home designs, and the compounded inequities faced by marginalized communities. While homeownership often acts as a "financial reservoir" to pay for in-home help, renters are frequently priced out of their communities exactly when they need stability most, notes Bergh, a PhD candidate at the NYU Rory Meyers College of Nursing. She points out that waitlists for affordable senior housing in some cities stretch up to eight years — a timeline that doesn’t align with the rapid health changes of an aging population. This "anemic supply" of housing often forces seniors to live in clinical settings they don't necessarily require. "When we talk to families and caregivers, this was not avoidable for them," Bergh explains. "This is sort of a last resort: They couldn't care for their family members as much as they wanted to. There just weren't the resources there." Repeated too often, that scenario fills nursing home beds that are increasingly in demand by hospitals and a growing number of seniors with complex health needs. Bergh urges clinicians to move beyond basic screenings for homelessness and begin identifying "proximal risks" like housing affordability and minor accessibility needs. Skilled nursing providers can play a role by learning about their short-term patients’ housing needs and suggesting resources such as rent-freeze or home modification loan programs. She says such solutions might help change some seniors’ long-term care trajectories.