The impact of cognitive decline and workload on the costs of dementia care

Abstract

AbstractCosts of dementia care and its relation to cognitive capacity, activities of daily living (ADL) and behavioural disturbances were studied in a prospective, non‐randomized concurrent control study. The participants consisted of 173 demented patients who at inclusion were cared for in four caring alternatives: 45 in home care, 55 in day care (DC), 49 in group living (GL) and 24 institutionalized patients in Sundsvall, an industrial city in northern Sweden. The use of institutional care and costs were constant for the GL patients, independently of cognitive capacity, ADL capacity and behavioural disturbances, while institutional care and costs of the home care patients and the DC patients increased when cognitive capacity and the ADL capacity deteriorated and behavioural disturbances increased. The main conclusion is that care in GL seems to be a caring alternative in which institutionalization figures and costs are independent of measurements of the degree of dementia. The costs for the municipality and the county council regarding the DC group were lower than GL, particularly in relation to impaired cognitive function. In the sensitivity analysis, however, where ‘hotel costs’ and the value of the families' informal work were included, the costs of the DC and the home care group increased considerably.