Expenditures in caring for patients with dementia who live at home.

Abstract

OBJECTIVES. Given the national interest in progressive dementia, we estimated expenditures incurred in caring for dementia patients who live at home. METHODS. Primary caregivers of 264 patients from a university-based memory disorders clinic were interviewed at baseline and asked to keep service use diaries for 6 months; 141 caregivers who returned the diaries are the focus of this report. We examined both formal and informal services (distinguished by whether money was exchanged) and associated expenditures. RESULTS. Neither caregivers returning diaries nor their patients differed at baseline from those not returning diaries and their patients. Expenditures incurred over 6 months were extensive for both formal ($6986) and informal ($786) services. Out-of-pocket expenditures were high (e.g., in-home companion or sitter, adult day care, visiting nurse). Multivariable analyses indicated that patients with more severe symptoms of dementia and families with higher incomes reported significantly higher expenditures. CONCLUSIONS. The expense of caring for patients with progressive dementia living at home may be higher than previously estimated and frequently involves expenses paid directly by patients and their families.

Hourly Care Received by People With Alzheimer's Disease: Results From an Urban, Community Survey

“…The NYC AD sample is, on the whole, older, more impoverished, and less healthy than the other Sample chosen evidently to exclude subjects with formal care, f r o m Coughlin & Liu (1989), Table 3, excludes mild/no cognitive impairment group, f r o m Weinberger et al (1993), sum from Table 3 (Adult day care category interpreted as hrs/week). Estimate from Rice et al (1993), Exhibit 1, "Social Services," valued at $9 = 1 formal hour.…”

“…Although estimates of hourly care received by people with AD are now available (Coughlin & Liu, 1989;Ernst & Hay, 1994;Ernst, Hay, Fenn, Tinklenberg, & Yesavage, 1997;Hu, Huang, & Cartwright, 1986;Huang, Cartwright, & Hu, 1985;0stbye & Crosse, 1994;Rice et al, 1993;Souetre etal., 1995;Stommel, Collins, & Given, 1994;Weinberger et al, 1993), these have been based, for the most part, on clinic or tertiary care referral series and have mainly involved cross-sectional samples. Much less frequent are analyses using longitudinal panels (Tennstedt, Crawford, & McKinlay, 1993).…”

The Cost of Dementia in Denmark: The Odense Study

“…Third, some studies only consider Alzheimer's disease [3,6]. Fourth, some studies only consider expenditures to the demented who live at home [7]. The present study adds information to earlier work by investigating a random sample of carefully diagnosed demented patients living at home or in institutions.…”

“…In this process, precise knowledge of the health care costs of dementia is crucial. A number of studies of the cost of dementia have been published [2][3][4][5][6][7]. However, first, these studies differ methodologically with respect to the types of costs to be included.…”

National Estimates of the Quantity and Cost of Informal Caregiving for the Elderly with Dementia*

“…However, the estimates of the average caregiver time and associated cost for dementia care have varied widely (from $1,500 4 to $35,000 5 per year), probably due to the use of small geographically restricted samples as well as differences across studies in average severity of cognitive impairment, definitions and methods for establishing a dementia diagnosis, and the``wage'' or``opportunity cost'' used to value informal caregiver time. 4±13 Only one prior study 7 used a nationally representative U.S. sample to evaluate informal caregiving for dementia, but that study did not adjust for important socioeconomic and family characteristics that have been shown to be important independent predictors of informal care.…”