Characteristics, Care, and Cost Across Settings*

As the disease progresses, so does the need for greater supervision, more help with activities of daily living, and eventually help with palliative and end of life care. The proportion of people with dementia increases with each higher level of care.

◆ Nursing Facilities◆ Residential Care Facilities◆ Home

Dementia in Maine 2013

Almost half the people receiving community and facility-based long term services and supports have dementia.

Number and percentage of

people in Maine’s Long Term Care

System Who Have Dementia (N=13,223)

44% Have

DementiaN=5,818

56%Don’t HaveDementiaN=7,405

Dementia Diagnosis by Setting

Home Care(N=4,044)

Residential Care(N=3,938)

Nursing Facility(N=5,241)

14%

86%

47%

53%

66%

34%

n Have Dementia n Don’t Have Dementia

79 64

69% With Dementia, Live With Others 31% Live Alone

Living status

49% Without Dementia, Live With Others 51% Live Alone

No Caregiver

Caregiver status by dementia diagnosis in the home care setting

Live-In Caregiver Live-Out Caregiver29% 47% 30% 26% 40% 27%

n Have Dementia n Don’t Have Dementia

Home Care(N=4,044)

Number of people with one or more falls in the past 30 days:

Residential Care(N=3,938)

Nursing Facility(N=5,241)

30% 26% 15% 13% 21% 15%

n Have Dementia n Don’t Have Dementia

Emotional SupportAverage hours of caregiver

support (per week)

Supervisory Support

Housekeeping (IADL) Help

Personal Care (ADL) Help

8 hrs7 hrs

19 hrs10 hrs

11 hrs8 hrs

11 hrs6 hrs

Have Dementia n Don’t Have Dementia n

Home Care Residential Care

Have DementiaDo Not Have Dementia

Average age of people with dementia by setting

Nursing Facility

83 79

84 77

*MED assessment data for persons using MaineCare or state-funded home care services at any time during SFY 2010, and MDS or

MDS-RC assessment data for all residential care and nursing facility residents listed on facility rosters as of March 15, 2010

With Dementia$204.1 mil

(46%)

WithoutDementia$243.4 mil

(54%)

Medicare$37.8 mil

(9%) Medicare$68.8 mil

(15%)

MaineCare$174.6 mil

(39%)

MaineCare$166.3 mil

(37%)

Total MaineCare and Medicare Payments for MaineCare Members (SFY 2010)

Home Care

MaineCare payments for people with dementia are concentrated in the nursing facility

Residential Care Nursing Facility

$6.1

$56.7 $37.3

$50.6

$123.6

$68.1

n Have Dementia n Don’t Have Dementia

Home Care

Average Per Person Per MonthMedicare and MedicaidPayments

Residential Care Nursing Facility

$1,738

n Have Dementian Don’t Have Dementia

n MaineCaren Medicare A-B

$1,221

$2,959 $4,657

$1,166

$5,823

$4,367

$811$5,178

$2,724

$880

$3,604

$2,679

$796

$3,474

$1,815

$1,156

$2,971

Home Care(N=555)

Residential Care(N=1,860)

Nursing Facility(N=3,452)

Cognitive Performance Scale (CPS)

People with Dementia

n CPS 0-2: Intact to mild impairmentn CPS 3: Moderate impairmentn CPS 4-5: Moderate/severe to severe impairmentn CPS 6: Severe Impairment

36%

29%

15%

43%

49%

44%

17%

22%

32%

4%

10%

ER Visits: The number of members with at least one ER visit

n Have Dementia n Don’t Have Dementia

45% 47% 37% 40% 22% 30%

Home Care

Residential Care

Nursing Facility

Hospitalizations: The percentage of members with one or more hospitalizations

n Have Dementia n Don’t Have Dementia

41% 38% 28% 40% 20%

Home Care

Residential Care

Nursing Facility

31%

SOuRCeS: To identify members by setting, we used MED assessment data for persons using MaineCare-funded home care services at any time during SFY 2010, and MDS or MDS-RCA assessment data for all MaineCare residential care and nursing facility residents listed on facility rosters as of March 15, 2010. We then used JEN Associates’ Integrated Medical Management Research System (iMMRS®) to link members to MaineCare and Medicare claims data.