APH 2004, 62, 143-156:
Care time and costs of care for elderly persons with dementia.
S. Misplon, J. Pacolet, G. Hedebouw
Keywords: Dementia, Costs and Cost analysis
Aim: List care activities of formal and informal carers and calculate
costs of care for elderly people with dementia. Comparison with those
not suffering from dementia (control group) at home and in residential
Methods: The combined methodology of a retrospective questionnaire
and a prospective diary was used to collect individual data on the
use of health care (professional and informal care).
Results and conclusions: For home care, we found that professional
care and costs of materials does not differ in any significant way
between the dementia group and the control group. Professional care
was on average 5,3 hours/week. However, we did observe a clear difference
with regard to the informal care. The recorded time of informal
carers was significantly higher for elderly persons with dementia (on
average 38 hours/week) than for elderly persons not suffering from
dementia (on average 16 hours/week).
In residential care facilities, the care time for dementia patients with
intensive need of care (Katz score C or Cd) was almost twice that dedicated
to dementia patients with slight to moderate need for care (score O, A or B on the Katz scale). However, this latter group did not differ
much from the control group (predominantly score O). Therefore we conclude
that the care categories indexed by the Katz scale provide, as
such, an explanation for the care costs charged in the facilities.
The residential setting has a great impact on care provision. The
recorded time spent by nurses and carers in home care is more than
twice that spent in residential facilities, despite the fact that more intensive
care situations are more likely to occur in residential care. This can
mainly be attributed to the presence of informal carers who provide a
great deal of nursing and care tasks.