A recent post in The New Old Age blog of the New York Times reported on a study of Medicare spending among patients with advanced dementia in Boston area nursing homes. The 300-person study showed that 30% of total Medicare expenditures for these patients was on hospitalizations and 10% on skilled nursing care after those hospital stays. This is an alarming statistic because recent studies have given evidence to the need for keeping dementia patients within a familiar setting, especially in later stages of progression.
“Being in an emergency room where people are taking blood and putting in IVs in this crazy, noisy setting [has] been described as ‘assault,’ and I concur,” explains Dr. Susan Mitchell of the Hebrew Senior Life Institute for Aging Research.
Dr. Mitchell estimates that about 75% of those hospitalizations were avoidable and adds that these patients could have been treated with equal effectiveness in the nursing home [or other settings].
Dr. Mitchell adds that part of the motive for hospitalization might be cost-shifting by nursing homes. Patients who return to the skilled nursing home after a three-day hospital visit will generate up to 100 days of skilled nursing care covered by Medicare, which will pay out a higher rate than the Medicaid or other long-term care plan that may have been covering them before. This gives the nursing homes an incentive to send out long-term patients to hospitals if even the slightest complication arises.
However, families also play a large role in this trend of hospitalizations. Many are not aware that as dementia progresses, the need for medical care increases as well. Planning for this level of care in advance is crucial because it limits the amount of unnecessary hospitalizations and the confusion for the patient that comes along with it. Families must consider the level of care that will be needed but also the preference of their loved one. No matter where their loved one is most comfortable, there is a medical service that can assist; from at-home care to specialized memory-care communities and even hospice services that can provide end-of-life care in any setting.
To learn more about services available for those with dementia or to ask a live professional about your specific needs visit: www.silveradosenior.com