New Research Reveals Costs of Dementia Care Higher than for Any Other Condition
The information in the latest research results by the National Institute on Aging (NIA) won't come as a shock to those caring for, or having cared for, someone with dementia. The information that out-of-pocket costs in the care for those with dementia in the last five years of life being 81% more than even the care for those with heart disease or cancer likely validates what families and spouses have long experienced.
The NIA's research involved the study of more than 1,700 people age 70 and older for the period 2005-2010, studying four sub-groups of people with diagnoses of likely dementia, heart disease, cancer, and other causes. Although the cost to Medicare were about the same for each of the sub-groups, out-of-pocket expenses for dementia at approximately $61,500 were substantially higher than for any of the other sub-groups at $34,000.
What does this mean to a population that is aging faster than those that are replacing it? How will the cost burdens be handled by not only those with dementia and their caregivers, but also society?
When out-of-pocket costs become prohibitive, either due to no savings, savings having been exhausted, family unable/unwilling to take on care costs, what will be the outcome for the dementia patient? In many instances, these people will then require the additional assistance of Medicaid, either in the community or in a long-term care facility. Since Medicaid is funded by tax dollars, will citizens be willing to pay what it requires to fund these costs or will other solutions be required?
I don't foresee simple solutions now or in the future. Answers will begin to depend largely the value of care of the aging. Will the younger generations, feeling the burden of care for those past retirement age, come to think enough is enough -- perhaps not out of choice, but necessity? If so, what then?
Resources: National Institutes of Health; Health care costs for dementia found greater than for any other disease ; 10-27-2015
Annals of Internal Medicine; The Burden of Health Care Costs for Patients with Dementia in the Last 5 Years of Life ; 10-27-2015
FOPP - Dementia - DementiaCareCosts - Medicare - Medicaid
Image Credit » https://pixabay.com/en/hands-walking-stick-elderly-981400/ by stevepb
Comments
markgraham wrote on October 27, 2015, 2:11 PM
I do not know and I was a practical nurse who cared for the Dementia/Alzheimer's patients of today and I do not know about what the younger generations will do when I am in need of care-giving. Who knows nursing homes might be computerized and if residents have a physical issue like incontinence a android might come into the room and change the resident if needed or do the nursing chores like humans do now or it could be like in the book "The Giver" by Lois Lowry. Again I am not sure what the future holds for this issue. Just have to wait and see.
1Lillybell wrote on October 27, 2015, 2:28 PM
I don't know, but something really needs to change. The cost of everything is just rising and rising, pretty soon no one will be able to afford what they need.
1Feisty56 wrote on October 27, 2015, 2:29 PM
I hear you...what I foresee is an embracing of euthanasia in the near future. Gone will be the brakes that society for the most part has put on this because it will become a practical solution. I would love to be wrong, but I believe it will happen in one form or another. Or maybe the government will put groups of older, unwell people on one of the many floating islands of garbage out in the ocean -- I prefer the first idea to the second.
Feisty56 wrote on October 27, 2015, 2:31 PM
As is my reply to &AbbyG above, I think something is going to give, either in the way of denied health care of people of certain ages or an embracing of euthanasia.
Feisty56 wrote on October 27, 2015, 2:33 PM
This is when I wish I were a fiction writer, because I can envision all sorts of scenarios.
Feisty56 wrote on October 27, 2015, 2:34 PM
I wish I were smart enough to begin to have any answers, but I really don't. I dislike discussing problems without having at least one solution to offer, but this is of such a scope I can't begin to see a solution -- at least not one that I like.
MegL wrote on October 27, 2015, 2:40 PM
It's a terrible dilemma. People are living longer and no matter what the illness, whether dementia, or the others you mentioned, people need to be cared for.
16snowroses.6doves4peace wrote on October 27, 2015, 3:51 PM
This is both frightening and disgraceful, Feisty. My Great-Grandmother had Alzheimer's Disease, and I can only imagine the burden that was left to her children both before and after her death. The financial burdens left to those who are in charge of caring for these people only slightly outweighs the emotional ones, I suspect.
1msiduri wrote on October 27, 2015, 4:23 PM
I agree. There is no simply or easy solution. I can understand why some traditional peoples abandoned their elderly or infirm once they became unable move with the tribe. The survival of the many depended on it. but frankly, if I were in that position, I would not object to a....hmmm.... hastened exit. Alzheimer's puts so much stress on the family that unless you're in the middle of it, it's hard to understand.
1Kasman wrote on October 27, 2015, 5:36 PM
Having worked as a carer looking after those with dementia and having seen my mother deteriorate with this devastating condition I can certainly relate to the fact that looking after a person with dementia is a 24/7 job and takes a lot of patience. During my career as a carer I worked 6 hours shifts and that was hard enough. How anyone can look after a dementia sufferer all day every day and not get frustrated or depressed is beyond me.
1markgraham wrote on October 27, 2015, 6:23 PM
I worked as a Licensed Practical Nurse in a geriatric psych unit that was primarily dealing with dementia and alzheimer's. I did that for 13 years and then two years in a nursing home before that. I did get frustrated and depressed at times then I started doing the activities with them when I had the chance. That helped for I got to see two sides of the care for this group.
1Kasman wrote on October 27, 2015, 6:31 PM
What is needed is a lot more support to keep sufferers at home where they are happiest if at all possible. It's been obvious for some time now that ''care in the community'' just doesn't work because it isn't funded adequately.
1markgraham wrote on October 27, 2015, 6:46 PM
How true. I am not sure if this fits, but when I did do the job i did I used my own materials. I do think that this kind of care should be done in the home and this is starting to happen to a point, but the care I provided is more at the end of the progression of the disease and the patient/sufferer is becoming to hard to handle in the home. sometimes when I was a nurse working with these patients and they got violent I wished we had hazardous duty pay for that is how bad some of these patients could get. I think what I typed makes sense.
1Feisty56 wrote on October 27, 2015, 7:51 PM
True, except for the person who pulled the trigger.
Feisty56 wrote on October 27, 2015, 7:55 PM
Although some might think me cynical, I think I'm being realistic in saying that the real crunch is going to come for us already near the 60-year-old mark or better, those of the huge Baby Boomer generation. It's going to come down to a numbers crunch for those younger than that to determine how to remain financially stable themselves and care for the elders in society.
Feisty56 wrote on October 27, 2015, 7:57 PM
It is frightening and the disgrace, I think, is in the ever-rising costs of health care, probably the world over, but particularly in the U.S. In decades to come, I think we'll need at least five-fold of the amount of nursing home beds we currently have.
Feisty56 wrote on October 27, 2015, 7:59 PM
Alzheimer's and other dementias are truly thieves -- first of the person with the condition and then on the purse strings and the lives of those who love and provide care for that person.
Feisty56 wrote on October 27, 2015, 8:02 PM
I had forgotten you worked as a carer. My thirty years of nursing were spent in long-term care, so I, too, am all too familiar with the issues of dementia. I would go home worn out after an 8-hour shift that I shared with three or four other people. As you stated, I cannot imagine being the only caregiver at home for a person with dementia. It is demanding work on so many levels.
Feisty56 wrote on October 27, 2015, 8:04 PM
That's true, markgraham , it's not all doom and gloom with dementia patients, especially in the early stages where some quality of life is still enjoyed.
Feisty56 wrote on October 27, 2015, 8:06 PM
Many of the states have a Medicaid program available to provide assistance with activities of daily living and light housekeeping so that older adults still safe to remain at home may do so. Unfortunately, when dementia advances and 24. hour supervision is needed, this program is unable to provide that. At that point if family or friends don't/can't provide that supervision, nursing home care becomes necessary.
Feisty56 wrote on October 27, 2015, 8:08 PM
Yes, the behavior changes and problems that can accompany dementia and Alzheimer's can be troubling for the caregiver if the patient lives at home. If the caregiver also happens to be the spouse, who is likely also an older person, the spouse's safety can be at risk.
msiduri wrote on October 27, 2015, 8:35 PM
Yes. A friend of mine is experiencing that now with her mother. Her mother has short term memory problems and will ask them same question three for times in a row. She doesn't do this to be annoying; she really doesn't remember asking the question or hearing the answer.
1Paulie wrote on October 28, 2015, 4:18 AM
Thanks for sharing this information. I have seen people with dementia and it is sad and bad.
1markgraham wrote on October 28, 2015, 10:26 AM
I totally agree with you on that one. That is in a way why I went back to school and went back to teaching and learn how to teach others to care for this group or at least learn ways to keep the elders occupied in some fashion. These elders believe it or not still want to be and feel productive especially the ones who are at the beginnings of the disease and they have seen the end results from others.
1markgraham wrote on October 28, 2015, 10:32 AM
The sad part about that is that nursing home staff are again overworked and the resident sits in a gerichair either bored out of their minds and fall asleep in the chair or they become very restless and the staff has only so many aides who are busy with others and that is when agitation becomes the problem. I do not know how to solve this issue for I do not know if there is a solution, but to pray.
1I think there are a few new medications for this disease but there are a lot of side effects to work around and along with other ailments that this generation may already have at the present time.
Feisty56 wrote on October 28, 2015, 10:59 AM
I don't know if your friend's mother has been to see her doctor, but if she is diagnosed with early Alzheimer's (as opposed to other dementias), she can be prescribed medication that has been shown to help stave off the later stages of the condition for a longer period of time. It's something she may want to consider.
Feisty56 wrote on October 28, 2015, 11:02 AM
The Activity Department in long-term care facilities is very important. What I've never been able to understand is why that department isn't staffed into the evening hours when restlessness is more prevalent (sundowner's syndrome).
Feisty56 wrote on October 28, 2015, 11:04 AM
It can be both of those for sure, Paulie .
markgraham wrote on October 28, 2015, 11:10 AM
I always wondered that too. When and where I worked it was up to the nursing staff to do activities to try and stave off the agitation and restlessness. We use to scarf dancing and read stories and poems and maybe if the patients were able play a game of cards or something like that. It was hard for a lot of my patients progressed so far that there was little to be done but to put some soothing music on the DVD player.
msiduri wrote on October 28, 2015, 1:49 PM
She's been diagnosed. I'm not sure what medications she's taking, but she's also been an insulin-dependent diabetic for decades and there are mobility issues. It's important to watch her diet because she forgets if she's eaten, which also complicates her diabetes. If no one is watching, she'll clean out the refrigerator. Happily, she is not combative (as Alzheimer's patients can become) but can be more like stubborn child at times.
1it's a complicated, stressful situation. There are also legal implications, which is a whole other can of worms.
Feisty56 wrote on October 28, 2015, 3:53 PM
It sure sounds as if your friend has her hands full! I hope she isn't the only one caring for/supervising her mom. Her own health could soon become an issue.
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