Do Those With Dementia Live Longer at Home or in a Nursing Home?

People who have dementia face a progressive disease that impacts their cognitive abilities, can change their personalities, cause hallucinations and impact their physical well being. Eventually those with dementia may need round-the-clock care, which family care givers may find difficult, if not impossible. Often those with dementia are placed in Maryland nursing homes or facilities that specialize in caring for dementia patients. Where will a person with dementia live longer — at home or in a nursing home?

A common fear is that an individual will not live as long in a nursing home. There is no definitive research showing that’s a valid fear. There are many variables that could play out. A person may be less supervised at home but more medicated at a nursing home. Employees at nursing homes may be better trained at caring for those with the disease, but family and friends at home are likely to know the person better.

As of 2015, Alzheimer’s disease and other dementias are estimated to be the 6th leading cause of death in the United States. Over the years, different studies have reached various conclusions:

• A study in the Journal of the American Geriatrics Society looked at more than 4,000 older adults who were studied for about five years. Researchers tracked the deaths of participants and found nearly half (46%) of those with dementia died at home; 19% were at a nursing home; and 35% were in a hospital when they died.
• A 2005 study found that two-thirds of dementia-related deaths occurred in a nursing home.
• A 2013 study analyzed 378 nursing home residents and found those with a diagnosis of Alzheimer’s disease (compared to residents with other types of dementia and with cardiovascular conditions) survived for a longer period of time in nursing homes.

Beyond where the person lives, there are other factors that impact the lifespan of dementia patients, according to Very Well:

• Weight: Extra pounds in middle age increases the risk of developing dementia. Extra pounds in older people with dementia is associated with a reduced risk of death in nursing homes.
• Antipsychotic Medications: Some studies have shown increased use of antipsychotic medicines is linked to an increased mortality rate for dementia patients. Well-run nursing homes should try to limit their use and not use these medications as a chemical restraint for residents who may be difficult to control. The use of a chemical restraint without a proper diagnosis and monitoring is illegal. These medications may be seen as an “easy out” when there is insufficient, untrained or poorly supervised staff. There is research stating that reducing such medications while increasing social interaction improves survival rates.
• Effectively Treating Behavioral and Psychological Symptoms of Dementia (BPSD): Another study of nursing home residents looked at the mortality rates of those with dementia receiving anti-depressant and antipsychotic medications. They found death rates were not impacted by whether a resident was getting a medicine, or which one they received; but they were affected by the effectiveness of the medicine in treating their BPSD. Those whose behaviors and emotional symptoms improved lived longer, no matter which medication was used.

Several risk factors are associated with an increased risk of death in dementia patients:

• Delirium is a disturbance in mental abilities that causes confused thinking and reduced awareness of the environment. A common cause of delirium is an infection.
• Those with dementia are more likely to fall and break a hip.
• Dementia patients are at risk of developing pneumonia (an infection causing a fluid build-up in the lungs).
• Those 85 years old or older are at a significantly higher risk of death from Alzheimer’s disease.

Negligent nursing homes often blame the disease itself for the deaths of their residents who have dementia.  Though Alzheimer’s  is a fatal disease, some nursing home deaths may have been hastened by over-medication, neglect and lack of proper supervision.

If your loved one with dementia has suffered neglect or abuse at a Maryland nursing home, we can help you address the situation and hold those responsible accountable for their actions. At the Law Offices of Roger S. Weinberg, you’ll find compassionate support and experienced advocates to help your family through the tough times. Call 410-825-3161 today to schedule a free consultation.