Medical care for elderly people with Alzheimer’s disease and other forms of dementia in the last five years of life costs far more than care for other major killers like cancer and heart disease, a new study reports.
The findings come from researchers at Mount Sinai Hospital in New York and other medical centers who studied records from 555 men and women in the Health and Retirement Survey, an ongoing federal survey of older Americans. They matched these records with those from Medicare, the government health insurance program for people over 65.
They found that Alzheimer’s and other forms of dementia cost, on average, more than $287,000 over those five years. That compared with about $175,000 for heart disease, and $173,000 for cancer care.
But health insurance covered about the same amount — $100,000 – for each of these diseases, leaving many families of people with Alzheimer’s picking up the difference. Families paid, on average, over $61,000 out-of-pocket for Alzheimer’s care, far more than the $34,000 that families paid for care for those without dementia.
“Our study emphasizes that all households face substantial financial risks near the end of life, regardless of disease,” the authors write. “However, households with patients with dementia face even larger risks, especially out-of-pocket and implicit costs of caregiving.”
Much of the extra costs involved expenses related to home health aides and others who helped those with Alzheimer’s carry out day-to-day activities like getting dressed, bathing and preparing meals. Alzheimer’s patients also cannot be left alone because, among other things, they wander and may risk serious injury.
Home health care costs, on average, about $20 an hour, the researchers estimated. But such expenses are not covered by Medicare and most insurance programs. The findings appeared in the Annals of Internal Medicine.
As other studies have shown, families also provide a disproportionate share of unpaid care in helping loved ones with Alzheimer’s disease compared to those with other illnesses.
Medicare and many insurance programs reimburse families, at least in part, for expenses like doctor visits, hospital stays, and medical procedures and tests. But much of the home health care or home nursing care 
required for people with Alzheimer’s is not reimbursed by insurance. And home care for Alzheimer’s may be required for many years.
It’s not surprising, then, that many families must spend down all the money they have in caring for a loved one with Alzheimer’s. The financial burden was particularly severe for African-Americans, those with little education, and widows, the researchers report.
“Health care expenditures among persons with dementia were substantially larger than those for other diseases, and many of the expenses were uncovered (uninsured),” the researchers conclude. “This places a large financial burden on families, and these burdens are particularly pronounced among the demographic groups that are least prepared for financial risk.”
By ALZinfo.org. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Amy S. Kelley, MD, MSHS; Kathleen McGarry, PhD; Rebecca Gorges, MA; and Jonathan S. Skinner, PhD: “The Burden of Health Care Costs for Patients With Dementia in the Last 5 Years of Life.” Annals of Internal Medicine 163: pages 729-736, October 26, 2015.
