Location of death as an indicator of end-of-life costs for the person with dementia

Abstract

Decreasing health resources and an aging population highlight the importance of end-of-life decisions. Estimates suggest that end-of-life care in a hospital is more expensive than other alternatives. This study examined the location of death for 3,109 Medicaid-eligible persons with dementia identified through the South Carolina Alzheimer's Disease Registry between 1988 and 1994 and estimated daily end-of-life costs. Results indicated that (1) daily costs for hospital care are six times higher than hospice/home care and (2) almost half of persons resided at home but only 8 percent died at home while 51 percent died in hospitals, the most expensive option. These findings suggest home or hospice end-of-life care might be a reasonable and cost-effective option for elderly patients with dementia. Families should be encouraged to explore this alternative.