Contemplative senior man at home

Dementia patients in their final months of life receive less home health and hospice, according to a new study

Researchers at the nonprofit research institute RTI International found people with dementia had a 12.5% likelihood of receiving hospice in the final month of life, compared to 17.5% of those without dementia. 

“Dementia is unique because of the long course of illness, which can complicate end-of-life care for people with dementia,” Ila Hughes Broyles, PhD, a health services researcher at RTI and lead author of the study, said in a statement. “Our study shows that current healthcare models for the disease are not always equipped for the sustained burdens of dementia, resulting in inadequate end-of-life care, or even none at all.” 

The study found that people with dementia functionally appear similar to those with other terminal illnesses for years prior to their death. For instance, dementia patients appear to have the same predicted average activities of daily living score at 17 months prior to death as people without dementia at six months prior to death. The study suggests that dementia patients may receive less home-based care because it is more difficult to identify when they are within six months of death, a requirement to receive end-of-life hospice care. 

RTI researchers used the Health and Retirement Study (HRS) linked with Medicare Claims to generate a series of generalized linear models. The models predicted functional status and healthcare use for patients with and without dementia during the final four years of life. 

Alzheimer’s and dementia patients are typically eligible for hospice if they are unable to walk, dress or bathe without assistance, become incontinent and are no longer able to communicate.