Factors influencing the cost of care and admission to long-term care for people with dementia in Ireland

Abstract

Objective

To explore the factors associated with the cost of care and admission to long-term care (LTC) for people with dementia living at home in Ireland.

Methods

Data on formal and informal resource use for people with dementia, and their LTC admission, were obtained from a national study of spousal dementia caregivers. Functional status was measured using the Bristol Activities of Daily Living Scale, while behavioural and psychiatric symptoms were evaluated using the Neuropsychiatric Inventory. Multivariable regression analysis was used to model costs and the predictors of LTC admission.

Results

Physical and cognitive symptoms were significantly associated with costs. Severely impaired functional ability was associated with a €2,308 increase in mean total 30-day monthly costs. Psychosis was associated with a €335 increase in primary and community 30-day monthly care costs. These factors also make it more likely that a person with dementia is admitted to LTC. Having an older caregiver also increases the risk of admission to LTC, while living in a rural area and having a female caregiver reduce the likelihood of admission.

Conclusions

Dependency matters for the cost of care. Physical and cognitive symptoms, caregiver age and gender, and geographic location are significant predictors of admission to LTC.

Keywords:

• Dementia
• cost analysis
• long-term care admission

Acknowledgements

The funders had no role in the design of the study; the collection, analysis, and interpretation of data; the writing of the paper; or the decision to submit the paper for publication.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Those who are bereaved at follow-up are treated as missing in the analysis.

Additional information

Funding

This work was supported by a Health Research Board Leader Award (RL - 2015 - 1587). Data collection was funded by the Alzheimer Society of Ireland and the Health Research Board under the Medical Charities Research Scheme [grant number MRCG/2012/8] and supported by the Atlantic Philanthropies [award number 11024].