Study: People with dementia more likely to die at home than in nursing home

A new study published in the Journal of the American Geriatrics Society reveals that many older adults with dementia live and die in community settings rather than nursing homes. This contradicts the commonly held view that most people with dementia eventually move to nursing homes and die there.

Researchers performed a combined assessment of more than 4,000 patients’ electronic medical records with their Medicare and Medicaid claims, as well as data on their home healthcare and nursing home care from 2001 to 20008. Of these patients, 1,523 had dementia.

While 74 percent of the time the individuals studied who had dementia went to a nursing home after hospitalization, they did not remain there. Approximately one quarter returned to the hospital in less than a month, but many of the remainder returned home.

Rather than finding individuals with dementia progressing on a straight line from home to hospital nursing home as presumed, the researchers found that individuals with dementia go back and forth between care settings. These care transitions can add to the complexities of care management and treatment and to stresses for family caregivers, the researchers wrote.

The researchers also determined that a majority of care for those with dementia, even advanced dementia, is provided in the community by families.

“Our beliefs are challenged regarding the permanence of nursing home care for persons with dementia,” said Robert L. Kane, MD, of the School of Public Health, University of Minnesota, and Joseph G. Ouslander, MD, Charles E. Schmidt College of Medicine, Florida Atlantic University, in an accompanying editorial in the journal. “More research is needed to understand how this impacts the quality of care for dementia patients and how we can improve care transitions and management for dementia patients and their families.”