Dementia patients receive fewer home health services, hospice care nears end of life

A new study has found that people with dementia receive less care at home and hospice in the last months of their lives.

The study suggests that despite being similar to patients with other terminal illnesses in terms of functionality, dementia patients may receive less home care because they are more difficult to identify when they are within six months of death.

The study was conducted by researchers at RTI International, a non-profit research institute.

According to the researchers’ findings, dementia was associated with significantly fewer hospice visits during the last three months of life.

“Dementia is unique because of the long course of the disease, which can make end-of-life care for people with dementia difficult,” Ila Hughes Broyles, RTI Health Services Investigator and lead author of the study, said in a statement. “Our study shows that current models of care for this disease are not always appropriate for the long-term burden of dementia, leading to inadequate or even non-existent end-of-life care.”

For patients without dementia, the probability of receiving hospice care in the last month of life was 17.3%. The probability of receiving hospice care in patients with dementia was 12.5%.

Not only did patients with dementia receive fewer home and hospice care services, the study authors also found that the same patients appeared to have the same predicted average daily activity (ADL) as those with similar diseases.

Patients with dementia had the same ADL score 17 months before death as people without dementia six months before death, indicating that it is difficult to assess patients with dementia without properly trained staff and caregivers.

The study also found that dementia is associated with less durable medical equipment, fewer home healthcare services, and fewer office visits.

In particular, according to the study, predicted use of home remedies was significantly higher for people with dementia between 48 months and 42 months before death, but significantly lower between 4 months and 1 month before death.

Source: RTI International

If an organization is engaged in home care, it is, at its core, caring for people with dementia.

The Population Reference Bureau estimates that 7 million people aged 65 and over have dementia in 2020. By 2030, this number should rise to 9 million, and by 2040 to 12 million.

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