Factors influencing the cost of care and admission to long-term care for people with dementia in Ireland

Objective: To explore the factors associated with the cost of care and admission to long-term care (LTC) for people with dementia living at home in Ireland. Methods: Data on formal and informal resource use for people with dementia, and their LTC admission, were obtained from a national study of spousal dementia caregivers. Functional status was measured using the Bristol Activities of Daily Living Scale, while behavioural and psychiatric symptoms were evaluated using the Neuropsychiatric Inventory. Multivariable regression analysis was used to model costs and the predictors of LTC admission. Results: Physical and cognitive symptoms were significantly associated with costs. Severely impaired functional ability was associated with a euro2,308 increase in mean total 30-day monthly costs. Psychosis was associated with a euro335 increase in primary and community 30-day monthly care costs. These factors also make it more likely that a person with dementia is admitted to LTC. Having an older caregiver also increases the risk of admission to LTC, while living in a rural area and having a female caregiver reduce the likelihood of admission. Conclusions: Dependency matters for the cost of care. Physical and cognitive symptoms, caregiver age and gender, and geographic location are significant predictors of admission to LTC.