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  • Writer's pictureChristopher Zambakari

Dementia Care Costs: From Treatment to Setting

Dr. Christopher Zambakari, B.S., MBA, M.I.S., LP.D.


Nathalia Zambakari, Board Certified AGACNP-BC

 

Under a single home care umbrella, Desert Haven Home Care, Apollo Residential Assisted Living, Oasis of Prescott, and Villa Fiore Assisted Living feature unparalleled care, service and advocacy in the compassionate treatment of senior citizens in need of medical attention. Offered in a familial setting, the facilities are teamed by professionals passionate about their work and fully engaged in the welfare of residents. Each facility proudly provides patient-centric supervisory, assisted and directed care, short-term respite stays and memory care support for Alzheimer’s and dementia patients.


The following brief on healthcare costs – particularly those associated with dementia care – is one in a series of regular informational blogs relative to the field of service, care and the treatment of our elderly.

 

The cost of healthcare, dementia or otherwise. Who wants to start?


Mark Twain once said that the weather was a subject of much discussion but that no one ever did anything about it. The cost of healthcare in this country is the same in that respect – lots of talk, but little action.


It is no secret the cost of care in the United States is among the highest in the world. Continued skyrocketing healthcare costs in the U.S. have captured the attention of policymakers, healthcare providers and patients – traveling from one administration through the next for years. According to the Centers for Medicare and Medicaid Services (CMS), national healthcare spending in this country reached $3.8 trillion in 2019, accounting for 17.7 percent of the country’s gross domestic product (GDP).[1] Most of this spending was concentrated in hospitals, physician and clinical services, and prescription drugs.[2]


Credit: LightField Studios / Shutterstock

Healthcare’s perfect storm


There’s more. While costs are one stormy cloud that seems to forever darken the horizon, the decreasing quality of care is a thunderclap that threatens a downpour of disastrous proportions.


Dementia care is especially impacted by the converging winds of cost-and-quality that bring uncertainty, stress and even fear to patients, caregivers and loved ones alike. Skilled nursing care, home healthcare and hospice are among the drivers of these costs. Different from diseases requiring expensive drugs, monitoring, tests and other expensive technology, dementia care requires time – 24/7 care costs are exorbitant.


Bigger picture: In 2019, the annual global societal costs of dementia were estimated at $1,313.4 billion for 55.2 million people with dementia, or about $23,796 per person with dementia. Of the total, no less than $213.2 billion (16%) were direct medical costs, a whopping $448.7 billion (34%) were direct social sector costs (including long-term care) and $651.4 billion (50%) in informal care costs.[3] As per one report, the obvious conclusion: The huge costs of dementia worldwide place enormous strains on care systems and families alike.[4]


Dementia care is especially impacted by the converging winds of cost-and-quality.

Generally, while the U.S. spends more on healthcare per capita than any other country in the world, the subsequent high costs have not translated into better health outcomes. In fact, the U.S. consistently ranks poorly when compared to other developed countries in terms of life expectancy, infant mortality rates, and other health indicators.[5] According to National Center for Health statistics, life expectancy at birth in the U.S. declined by nearly a full year, dropping from 77 years to 76.1 between 2020 and 2021 – the lowest life expectancy level since 1996.[6]


It is time the factors contributing to cost increases are identified and dissected for a cure. It is high time solutions to improve the quality of dementia care are explored and implemented.


Cost factors


The high costs of healthcare here are due to a variety of factors, including administrative costs, expensive medical technologies and a fee-for-service reimbursement system that incentivizes providers to order more tests and procedures. Additionally, lack of price transparency, high drug prices and a fragmented healthcare system are some of the factors that contribute to the high costs.[7]


And, these high costs don’t even get you to the front of line, so to speak. In fact, access to healthcare remains a major issue in the United States. Millions of Americans lack health insurance, and many who have insurance still face high deductibles and out-of-pocket costs.[8]


Where to call home: small could be big


But what about facilities? Another factor in care costs is the living space, the setting, especially for a patient with dementia. The lack of such space – assisted living options – is a culprit in climbing costs. In an ironic twist, while smaller home care options outnumber larger facilities, a full 70 percent of individuals prefer larger, 50+-bed residences.[9] Many dementia patients are placed in large facilities, which are more expensive and less personal than smaller residential settings. Large home care facilities often lack sufficient staffing, resulting in the absence of the individualized attention they require. Furthermore, the environment in these large facilities can be overwhelming and isolating for dementia patients, which can lead to depression and a further decrease in quality of care.


Often more affordable than larger facilities, smaller residential settings provide individualized attention for each patient.

In comparison, small residential settings such as group homes can be better suited for dementia care. Often more affordable than larger facilities, these settings provide individualized attention for each patient, allowing for tailored care plans that can improve their quality of life. Group homes also provide a more home-like atmosphere, allowing patients to feel more connected to their families and the outside world.


Care cost assistance


Financial resources may be available to help cover the costs of care for a person with dementia. Some may apply now and others in the future.


The Alzheimer’s Association reports that, in addition to Medicare, the person with dementia may qualify for a number of public programs. These programs provide income support or long-term care services to people who are eligible. This includes Social Security Disability Income (SSDI) for workers younger than 65, Supplemental Security Income (SSI), Medicaid, veteran benefits and tax deductions and credits.[10]


In the end, the forecast ahead for quality dementia care and the cost of that care is cloudy at best. The policymakers, the healthcare providers and the patients and their caregivers and loved ones are all part of the equation. Policymakers can lead the charge to effect meaningful change, putting healthcare under a spotlight for all the right reasons – to influence and ensure advancements in the ways we treat and deal with neurological diseases. Healthcare providers must explore and institute care models capable of controlling costs without sacrificing critical areas of care – both physical and emotional. Those impacted by dementia must be vocal advocates for change. These “hidden victims” must get informed in order to make better decisions about the level of care, the care setting and the role they play in providing the best chance for a modicum of quality of life for those suffering.


References

[1] Centers for Medicare and Medicaid Services. (2021). National Health Expenditures 2019 Highlights. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.

[3] Wimo, A., K. Seeher, R. Cataldi, E. Cyhlarova, J. L. Dielemann, O.Frisell, M. Guerchet, et al."The Worldwide Costs of Dementia in 2019." [In eng]. Alzheimers Dement (Jan 8 2023).

[4] Ibid

[5] The Commonwealth Fund. (2020). “Mirror, Mirror 2020: Reflecting Poorly.” Retrieved from https://www.commonwealthfund.org/publications/fund-reports/2020/jan/mirror-mirror-2020.

[6] CDC, CDC, National Center for Health Statistics, https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20220831.htm.

[7] The Commonwealth Fund. (2020). “Mirror, Mirror 2020: Reflecting Poorly.” Retrieved from https://www.commonwealthfund.org/publications/fund-reports/2020/jan/mirror-mirror-2020.

[9] Intriago, Joy. “The Perfect Assisted Living Facility Size.” Seasons, March 31, 2022. https://www.seasons.com/the-perfect-assisted-living-facility-size/2492248/.

[10] “Paying for Care.” Alzheimer's Disease and Dementia. Accessed May 7, 2023. https://www.alz.org/help-support/caregiving/financial-legal-planning/paying-for-care.

 

About the Authors

Dr. Christopher Zambakari, B.S., MBA, M.I.S., LP.D.


Christopher Zambakari is the owner and operator of four Arizona-based assisted living care homes – Desert Haven Home Care in Phoenix, Apollo Residential Assisted Living in Glendale, Oasis of Prescott and Villa Fiore Assisted Living in Prescott Valley. He provides direction and oversight to a team of licensed medical and caregiving professionals to ensure the highest levels of customized care, service and advocacy at each of his facilities.


Nathalia Zambakari, Board Certified AGACNP-BC


Nathalia is a board-certified Acute Care Nurse Practitioner and a licensed medical professional responsible for short-term care patients suffering from severe conditions. As part of the care team, Nathalia reviews the medical records of incoming residents, helping to manage patient regimens and performing caregiver education to ensure the best care, service and advocacy for her residents-in-care.

Disclaimer

The material presented on this blog does not constitute medical advice. We encourage you to consult your primary care physician (PCP). The statements in this blog are not intended to diagnose, treat, cure or prevent any disease. Always consult your personal physician for specific medical advice. If you or your loved one is considering the benefits of quality assisted living, please contact us at 602-670-9326, or email us at info@deserthavenaz.com.



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