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American Journal of Alzheimer's Disease and Other Dementias®
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Location of death as an indicator of end-of-life costs for the person with dementia

Marcia J. Lane, MPH

Dorothy R. Davis, BA

Carol B. Cornman, BS, RN, PA

Caroline A. Macera, PhD

Maureen Sanderson, PhD

Alzheimer's Disease Registry and Department of Epidemiology and Biostatistics, School of Public Health, University of South Carolina, Columbia, South Carolina

Decreasing health resources and an aging population highlight the importance of end-of-life decisions. Estimates suggest that end-of-life care in a hospital is more expensive than other alternatives. This study examined the location of death for 3,109 Medicaid-eligible persons with dementia identified through the South Carolina Alzheimer's Disease Registry between 1988 and 1994 and estimated daily end-of-life costs. Results indicated that (1) daily costs for hospital care are six times higher than hospice/home care and (2) almost half of persons resided at home but only 8 percent died at home while 51 percent died in hospitals, the most expensive option. These findings suggest home or hospice end-of-life care might be a reasonable and cost-effective option for elderly patients with dementia. Families should be encouraged to explore this alternative.

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 13, No. 4, 208-210 (1998)
DOI: 10.1177/153331759801300408
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