There was a higher death rate and rate of using hospice in residents with Alzheimer’s disease or a related dementia receiving memory care treatment at assisted living communities compared to those at the facilities without the specialized memory care, according to a new study.
Researchers compared end-of-life outcomes in terms of death, hospice use and the number of days a person received hospice care during their last month of life. The team compared those factors in residents at long-term care communities with memory care to those at communities that did not provide memory care, the study published April 3 in the Journal of the American Geriatrics Society found.
The investigators used data from 15,152 fee-for-service Medicare beneficiaries with Alzheimer’s disease or a related dementia who moved to large assisted living care communities between 2016 and 2018. All of the memory care had more than 25 beds. People in memory facilities were 83.9 compared to 81.6 years old at general facilities, and less likely to be Black. Of the participants, 12.3% at memory facilities were dually eligible for Medicare and Medicaid compared to 28.4% of people at general facilities.
The rate of death during that time span was 13.4% of people in assisted living communities and 15.8% of people in facilities with memory care. Of the people, 8% in facilities and 10.6% of people in memory-care communities used hospice. People in memory care units used hospice about 1.4 days more during the last month they lived.
Data showed a 9.7% higher relative mortality rate among people with Alzheimer’s or a related dementia who moved to memory-care assisted living, compared to those who moved to assisted living without memory care. There was also a 17.5% higher relative rate of hospice use in people at memory care assisted living communities.
The higher death rate in memory care facilities doesn’t show that the quality of care is worse, the authors said. The team believes that residents who opt for memory-centered facilities may have more severe symptoms that they didn’t see in their data, as previous evidence shows that people in specialized facilities have a higher level of cognitive impairments and/or behavior disturbances.
“Memory-care assisted living may promote hospice utilization at the end of life and/or attract residents closer to the end of life,” the authors wrote.
Read more McKnight’s coverage of this study.
