A new study found that people with dementia receive less home health and hospice care in the final months of their lives.
The study suggests that – despite appearing similar to those with other terminally ill diseases on a functionality basis – dementia patients may receive less home-based care because it is more difficult to identify when they are within six months of death.
The study was done by researchers at RTI International, a nonprofit research institute.
Dementia was associated with significantly less hospice during the final three months of life, according to the researchers’ findings.
“Dementia is unique because of the long course of illness, which can complicate end-of-life care for people with dementia,” Ila Hughes Broyles, a health services researcher at RTI and lead author of the study, said in a statement. “Our study shows that current health care models for the disease are not always equipped for the sustained burdens of dementia, resulting in inadequate end-of-life care, or even none at all.”
For patients without dementia, the likelihood of receiving hospice care in the last month of life was 17.3%. Patients with dementia had a 12.5% likelihood of receiving hospice care.
Not only did dementia patients receive less home health and hospice care, but the study’s authors also found that those same patients appeared to have the same predicted average activities of daily living (ADL) score as patients with similar diseases.
Dementia patients had the same ADL score at 17 months before death as people without dementia at six months before death, which indicates that it’s difficult to assess dementia patients without properly trained staff and caregivers.
The study also found dementia was associated with less durable medical equipment, less home health care and fewer office visits.
Specifically, predicted home health use was significantly higher for people with dementia from 48 months to 42 months before death, but significantly lower from 4 months to 1 month before death, according to the study.
If an organization is in the business of home-based care, it is inherently in the business of dementia care.
In 2020, the Population Reference Bureau estimated there were 7 million people aged 65 and older living with dementia. By 2030, that number is supposed to climb to 9 million, and then to 12 million by 2040.