According to a recent study, people suffering from dementia receive less health care in their last months of life – particularly home health and hospice – than people without dementia who have terminal illnesses. Researchers at RTI International, a nonprofit research institute, published these findings from their recent study in The Gerontological Society of America.
The goal of the study was to determine if end-of-life trajectories are different for people with and without dementia. Researchers used data from the Health and Retirement Study linked with Medicare claims from 2000 through 2012 to analyze the relationship between functional status and dementia status. Relationships between dementia status and health care use and expenditures by service type were also evaluated.
The study concluded that dementia cases were associated with significantly less hospice during the final three months of life. Individuals with dementia had a 12.5% likelihood of hospice in the last month of life compared to 17.3% for those without dementia.[1]
End-of-life functional patterns are different for those with and without dementia. Those without dementia tend to have a sharp functional decline the year before death, while individuals with dementia might have sustained functional impairment for up to four years before the end of their lives. Researchers noted that the longer decline for those with dementia could make it more difficult for physicians and families to determine when the person is within 6 months of death.
According to lead author and researcher Ila Hughes Broyles, Ph.D., “Our study shows that current health models for the disease are not always equipped for the sustained burdens of dementia, resulting in inadequate end-of-life care, or even none at all.”[2]
February 2023 – C. St. John
[1] Broyles, I. H., Li, Q., Palmer, L. M., DiBello, M., Dey, J., Oliveira, I., & Lamont, H. (2023). Dementia’s unique burden: Function and health care in the last 4 years of life. The Journals of Gerontology: Series A. https://doi.org/10.1093/gerona/glad003
[2] RTI International. Study finds people with dementia receive less health care in their final months than people without the disease. RTI Newsroom. (February 6, 2023). Available at: https://www.rti.org/news/study-finds-people-dementia-receive-less-health-care-their-final-months-people-without-disease