Gaps in Dementia Care May Lead to Unnecessary Nursing Home Placement, Study Says

A lack of help with activities of daily living, home modification and maintenance and access to resources and services can lead to dementia patients being placed in nursing homes unnecessarily, a recent study in the Alzheimer’s & Dementia Journal found.

This study in particular looked at patients of Black, Hispanic/Latino and white ethnicities. In the study, researchers recognized seven distinct categories of unmet needs in patients living with dementia from 61 interviews conducted in New York. These categories included:

• Assistance with activities of daily living and basic home maintenance
• Access to resources and services
• Treatment-related services
• Opportunities for socialization
• Recognition of individual preferences
• Home function, such as unaddressed modification needs
• The availability, capability and support of family caregivers. 

Notably, barriers to addressing these needs were reported as limited awareness, knowledge, availability, affordability and acceptability of existing resources, services and supports.

The research involved interviews with patients living with dementia, their family care partners and key informants which were nursing home staff from two care facilities and aging policy experts. The authors of the study emphasized that several socioeconomic factors played into receiving proper care. Some barriers included insurance issues, lack of available workers and facilities having proper staffing. 

Key Takeaways

• Seven unmet needs categories were identified, including daily living assistance, resource access and caregiver support, highlighting gaps in community-based services for dementia patients.
• Barriers to addressing these needs include limited awareness, affordability and cultural tailoring, impacting Black and Latino families disproportionately.
• Systemic preferences are a huge barrier for nursing home care, complex Medicaid rules and workforce shortages, limiting home-based care options.
• The study emphasizes the need for culturally competent care and increased Medicaid-funded homecare.