THE IMPACT OF COGNITIVE DECLINE AND WORKLOAD ON THE COSTS OF DEMENTIACARE

Costs of dementia care and its relation to cognitive capacity, activit ies of daily living (ADL) and behavioural disturbances were studied in a prospective, non-randomized concurrent control study. The participa nts consisted of 173 demented patients who at inclusion were cared for in four caring alternatives: 45 in home care, 55 in day care (DC), 49 in group living (GL) and 24 institutionalized patients in Sundsvall, an industrial city in northern Sweden. The use of institutional care a nd costs were constant for the GL patients, independently of cognitive capacity, ADL capacity and behavioural disturbances, while institutio nal care and costs of the home care patients and the DC patients incre ased when cognitive capacity and the ADL capacity deteriorated and beh avioural disturbances increased. The main conclusion is that care in G L seems to be a caring alternative in which institutionalization figur es and costs are independent of measurements of the degree of dementia . The costs for the municipality and the county council regarding the DC group were lower than GL, particularly in relation to impaired cogn itive function. In the sensitivity analysis, however, where 'hotel cos ts' and the value of the families' informal work were included, the co sts of the DC and the home care group increased considerably.