Providing multiple long-term care services for people with dementia can bring great benefits to their caregivers

By Su-Yuan Chan and Dr. Ya-Mei Chen

One goal of long-term care (LTC) services is to support heavy caregiving responsibilities of caring for people with dementia. Our research examined 10,000 caregivers’ health utilization and costs in Taiwan and found that providing multiple LTC services for people with dementia significantly benefits their caregivers.

The article “The Impact of Multiple Long-Term Care Services Use on Dementia and Nondementia Caregivers’ Health Care Utilization and Costs” was recently published by the Journal of Applied Gerontology (JAG) in the November 2022 issue.

The research findings showed that among care recipients who prescribed a single LTC service, dementia caregivers had significantly more emergency department (ED) visits and higher total fees than nondementia caregivers. However, among care recipients who received multiple LTC services, the differences in healthcare services use between dementia caregivers and nondementia caregivers were insignificant, and dementia caregivers even had lower per-visit outpatient fees.

We analyzed two nationally representative datasets in Taiwan. We retrieved data for 10,771 caregivers: 5610 providing care to older adults with dementia and 5161 for older adults without dementia. The study then examined the effects for 1 year after care recipients’ initial prescription of single or multiple LTC services on their caregivers’ healthcare services, including outpatient, ED, and inpatient services.

The results suggest that using single or multiple LTC services substantially impacted dementia and nondementia caregivers’ health. More specifically, for care recipients who used a single LTC service, dementia caregivers had 0.82 more ED visits and 10.4% higher total fees than nondementia caregivers. This situation might arise because dementia caregivers’ needs were unmet, and their health was negatively affected when care recipients received only a single LTC service. Furthermore, dementia caregivers were more likely to neglect their own health and thus use more acute care healthcare resources. Therefore, with a single service use, dementia caregivers might still be under substantial stress and not have time to take care of their healthcare needs.

However, on the other hand, dementia caregivers can be better supported with multiple LTC services use. To elaborate, for care recipients prescribed multiple LTC services, dementia caregivers and nondementia caregivers used healthcare services at similar levels, and dementia caregivers had 3.5% lower per-visit outpatient fees. This finding might indicate that when using multiple LTC services, dementia caregivers can seek primary care services (e.g., outpatient services) when needed. Additionally, the severity of each dementia caregiver’s outpatient visit might have been even lower than that of nondementia caregivers, which led to lower outpatient fees. Accordingly, with multiple LTC services, dementia caregivers could maintain their health similarly to nondementia caregivers.

In summary, our findings emphasize the benefit to caregivers of multiple LTC services use among older adults, particularly care recipients with dementia. It is highly recommended for policymakers and researchers to focus on (1) the moderating effect of multiple LTC services use on dementia caregivers’ and nondementia caregivers’ health care utilization; (2) developing effective interventions and their combination with multiple LTC services for people with dementia and their family caregivers.

Also, in addition to promoting better-coordinated LTC services for caregivers, it is crucial to examine why caregivers might use fewer LTC services. In our study, the study population used only 2.38 LTC services on average. Hence, promoting multiple LTC services may be society’s next challenge.

Article Details
The Impact of Multiple Long-Term Care Services Use on Dementia and Nondementia Caregivers’ Health Care Utilization and Costs
Su-Yuan Chan, Hsiao-Wei Yu, Ming-Ching Yang, Yue-Chune Lee, and Ya-Mei Chen
First Published Online July 9, 2022
DOI: 10.1177/07334648221114110
Journal of Applied Gerontology

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