Of particular concern is the economic burden that providing care for those living with dementia will have on their families, who offer the bulk of support for such patients. Many households are left paying out-of-pocket for long-term-care costs until the patient's private assets are exhausted, which then makes them eligible to receive Medicaid.
“As baby boomers reach the ages of highest dementia risk, the nation faces urgency in finding ways to improve long-term services and supports specifically for this condition,” said study lead author Regina Shih, a senior behavioral scientist at RAND, in a written statement. “This issue is critical for families and loved ones who provide the bulk of dementia care.”
Government and private-sector efforts to improve the financing and delivery of dementia care have so far failed to come up with any viable solutions. Congress repealed the Community Living Assistance Services and Supports Act provision of the Affordable Care Act, which would have created a voluntary insurance system to cover some long-term-care costs. Critics said it was financially unsustainable.
Public long-term-care insurance is but one of the policy options the RAND study recommends lawmakers explore. Others include increasing public awareness and reducing the stigma associated with dementia, improving access to long-term-care services, and providing better support for family members serving as caregivers.
“There is no one single path that is the best one to follow to provide better care for people with dementia and improve support for their caregivers,” Shih said. “But what is clearly needed is more and quicker action around a set of recommendations to respond to this large and growing problem.”
Other studies have estimated the prevalence of dementia and the costs associated with long-term care to be much higher than reported in the RAND study. A 2013 report from the Alzheimer's Association (PDF) estimated more than 5 million Americans currently live with Alzheimer's, the most common form of dementia, with total costs for providing long-term care at $203 billion in 2013 and projected to rise to $1.2 trillion by 2050.
According to that report, medical expenditures will also increase as a result of dementia, since dementia patients average more than three times as many hospital admissions a year, and are more likely to have more serious chronic conditions that lead to hospitalization than those elderly not living with the illness.
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