Dementia
Study: few people with dementia get a dementia care unit bed after a hospital stay
A JAMA Network Open study of 1.4 million Medicare patients with dementia found only about 18% of those who moved into long-term care went to a facility with a dementia unit, with gaps by race and distance.
Key facts
- Only about 18% of new long-term care residents with dementia went to a facility with a dementia unit.
- Rates were lower for Black and Hispanic patients.
- Living near a unit made a big difference.
What happened
A study published November 2 in JAMA Network Open looked at about 1.43 million people with dementia in traditional Medicare who were hospitalized between January 2018 and August 2019. Researchers from Emory University and other schools tracked who moved into long-term care within six months, and whether that facility had an Alzheimer's special care unit, a separate unit designed for residents with dementia.
About 8.6% became long-term care residents. Among them, only about 18% went to a facility with a special care unit. Admission rates to those facilities were 1.46% for white patients, 1.01% for Black patients and 0.71% for Hispanic patients. The authors say differences between hospitals explain much of the gap, and distance mattered: about 34% of residents living within roughly 4 miles of a facility with a unit got one, versus about 3% living 24 miles or more away. The data are from 2018 and 2019 and leave out Medicare Advantage.
What it means for families
Dementia care units are scarce, and the hospital discharge process plays a big role in where a person goes next. Families who ask early have more choices.
The study measured access, not quality of care, and it does not say one setting is right for everyone.
In New York, the hospital must give you a written discharge plan. You can ask the discharge planner which nearby homes have a dedicated dementia unit and how to get on their lists.
What to do this week
- If a parent with dementia is hospitalized, ask the discharge planner early about dementia units nearby.
- Ask each home whether it has a separate dementia unit and how many beds are open.
- Visit or call more than one place before agreeing to a transfer.
Sources
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