Number Crunching with Dementia

A report by the Health Foundation in October 2011 has provided some estimates of potential financial savings that could be made by treatments and support for people with dementia.

This table takes a bit of time to absorb – of course the figures are estimates, and I can’t comment on the accuracy or efficacy of the sums.  But they give us an idea of the amounts of money we are talking about, that is, how much each parent, spouse, grandparent, each person with dementia costs to care for.

There are several things that can be pulled from this. Firstly, the importance of seeking and accepting support early on, despite being counter intuitive to many, actually can have a positive financial effect, as well as maintaining the quality of life we expect by retaining independence and membership of our community. It also highlights the cost of complications including infections and fractures, both of which may be to some extent preventable with good information and support to people with dementia and their family carers. The complications experienced within hospital also may be reduced by good quality dementia care – which is not universally provided at the present time. Once again, dementia’s unique place between health and social care means efficiency is dependent on convergent, symbiotic practices. The report also notes that the implementation of the National Dementia Strategy will create a £1.35 billion deficiency, after the £533 million it will save, which in other words is an acknowledgement that the necessary changes in provision for people with dementia should not be squeezed or confused with altering service provision to cut costs. Schemes such as direct payments and personal budgets are therefore only going to be effective in terms of supporting people with dementia if they are not constrained and governed solely by the need to save money. The final point I wish to make (although not the final point that can be made) is the financial cost of prescribing anti-psychotic drugs needlessly and without benefit. With good quality diagnosis, early treatment and support for family carers, including knowledge of how to reduce the risk of delirium, altering the elements which can be changed, including environment and caring approaches to alleviate certain situations, higher level needs can be supported without anti-psychotic medication.

The entire report can be found here: http://www.health.org.uk/public/cms/75/76/4181/2703/Spotlight_Dementia%20Care.pdf?realName=55ojeV.pdf  

Estimated costs of care for people with dementia and potential savings (found on p33 of The Health Foundation’s report, linked above)

	Estimated Costs	Potential For Savings
	Direct healthcare costs £8bn a year in UK. Memory clinic service for early diagnosis: £220m a year in England.	Cost saving after six years if use of memory clinics for early diagnosis leads to 20% or more reduction in need for residential care.
	Anti-Alzheimer drugs: £720 per patient per year (assume £60 per month). Excess bed-days in acute hospital: £1,400 per week. Clinical leader to implement dementia care pathway in every acute trust: £3m a year in UK.	12% reduction in need for residential care in people with mild to moderate dementia treated for six months or longer. £117m if length of stay is reduced by seven days for every inpatient with dementia admitted for fractured hip, chest infection, urinary tract infection or mini stroke. £700m if length of stay reduced by two days for every inpatient with dementia by providing psychiatrist-led multidisciplinary assessment, or intermediate care. Assuming 25% of people aged 60+ admitted have dementia, and excess bed cost is £200 per day. £38m from seven day reduction in hospital admissions from use of hospital at home scheme £400 per patient whose length of stay is reduced by two days from use of psychiatrist-led assessment of all elderly patients admitted to hospital
	Inappropriate use of medication: £84m a year for 140,000 people in England given antipsychotic drugs who are unlikely to benefit and may be harmed by them	£84m a year from stopping inappropriate use of antipsychotic drugs (assume £600 for one year’s treatment per patient)
Social Care	Long-term residential care: £9bn a year in UK. Community social service costs: £2.4bn. Home care: £150 per week. Day care: £90 per week. Residential care: £500 per week, £26,000 per year	18% fewer people needing residential care after two years with care management to coordinate health and social care. £14,000 reduction in costs of residential care from psychosocial care given to carers (200 day delay in need for residential care).
Costs to the patient, family and other informal carers	Costs of informal care: £12bn a year for UK. £270 per patient per week if carer time estimated at minimum wage	£1,280 saved per patient over three months from an occupational therapy training service for carers

 As always if you require any information on supporting someone with dementia in Trafford, please do not hesitate to contact us on 0161 746 3944.