A new study shows how much damage Dementia does to a person’s finances – as well as the higher demands it places on their family members.
People diagnosed with dementia saw their out-of-pocket spending for health care more than double and their net worth decline by more than 60 per cent within the first eight years of being diagnosed, a new study finds.
Other people of similar ages and in similar health, but without dementia, didn’t see much change in either financial measure in that time, according to the findings published in JAMA Internal Medicine by researchers from the University of Michigan.
The imact of the condition extended to family members. By the end of their second year after the onset of symptoms, people with dementia needed three times more hours of care from family and friends than their peers without dementia did.
People with dementia also entered nursing homes at nearly five times the rate of their peers in those first two years. Those who had less family support available were much more likely to enter a nursing home.
Additionally, people with dementia were much more likely than their peers to use paid in-home care, which is often not fully covered by federal health insurance provider, Medicare.
The new analysis uses data from nearly 2,400 adults who participated in the Health and Retirement Study, a long-term in-depth study based on interviews and health exams.
“The differences between these two groups, both in terms of use of care and financial impacts, were even larger than we had expected,” said HwaJung Choi, PhD, the study’s lead author and a health economist and research associate professor in the U-M Medical School’s Department of Internal Medicine.
“What we found regarding unpaid caregiving from family and others is the most striking and persistent care use difference, with 45 hours per month on average for people with dementia, compared with 13 hours for those without, by the end of two years,” added Choi, who is also a faculty associate at ISR. “The difference remains sustained at that level across eight years.”
With 6.7 million Americans currently diagnosed with dementia, and an increasing number expected to receive that diagnosis in coming years, Choi said it is critical to get a realistic picture of these impacts to inform policy decisions at the state and national level.
At the time before their dementia diagnosis, study participants’ wealth averaged $79,000 when all assets and debts were counted. Overall, the wealth of the peer group without dementia was about the same.
Both groups had annual out-of-pocket spending for medical expenses such as co-pays, deductibles, over-the-counter purchases and home care of about $4,000 at baseline.
By the end of two years, people with dementia saw their average wealth drop to $58,000, and their out-of-pocket costs double to around $8,000. Their peers saw neither of these impacts.
By the end of eight years, people with dementia had spent twice as much as their peers out of their own pockets for health expenses and had seen their wealth drop to an average of $30,500 while their peers saw no significant drop.
“What we’re really seeing here is two very different situations over a relatively short time for very similar families, determined just by a single diagnosis,” said Connell. “It’s a really striking comparison and may be driven largely by the ‘spend down’ of assets by many families in order to qualify for Medicaid coverage of long-term care in a nursing home.”
Keeping people with dementia living in their home or a non-nursing home setting such as assisted living is a key goal of major policy proposals – but means that Medicare, rather than Medicaid, would pay more of the cost.
