A study of Medicare patients has found that the costs for caring for a patient with dementia in the last five years of life are far higher than the costs for caring for patients with either heart disease or cancer in that time.
The study found that the average total cost of care for a dementia patient the last five years of life was $287,038, while for a heart patient it was $175,136, and for cancer patient it was $173,383. Medicare paid about $100,000 for the care of all three types of patients, but the care for dementia patients involved many expenses that were not covered.
The average out-of-pocket costs, the ones that insurance does not cover, for a patient with dementia was $61,522, which is more than 80% higher than the cost for someone with heart disease or cancer. Dementia care costs so much more because caregivers need to help them with basic activities like eating, dressing and bathing, and provide constant supervision. The costs of these types of care are not covered by Medicare.
In this study, researchers led by Dr. Amy S. Kelley, a geriatrician at Icahn School of Medicine at Mount Sinai in New York, used data from a federally funded survey that conducts regular detailed interviews with a representative sample of older people. It collects data on participants' incomes, health, and needs for care, as well as their cognitive functioning, and their total out-of-pocket spending for healthcare. The survey links to the Medicare database of total medical costs for the participants. After participants die, their families are questioned again about healthcare spending. To estimate the costs of unpaid care, such as care by a family member, the researchers used $20 an hour.
The big disparities in out-of-pocket costs for the three diseases are because Medicare covers services like office visits and acute care such as hospitalization and surgery, which tend to be the care that heart and cancer patients tend to receive. They generally do not need full-time home or nursing home care. Dementia patients, in contrast, need constant care for years.
The study was published in the Annals of Internal Medicine.