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Dementia patients end up in the ER 73% more often if their caregivers are depressed

Dementia patients whose caregivers are depressed have to visit US emergency rooms 73 percent more frequently than patients whose caregivers are in better mental health, according to new research. 

More than 16 million Americans care for parents, spouses or other loved ones with dementia without pay or professional assistance. 

Not only is this a financial hardship costing them hundreds of billions of dollars, collectively, but these caregivers suffer isolation and enormous stress as they watch the mind of someone they love slip away. 

Caregivers need care, too, as their depression creases the odds their family member will end up in an emergency department, warns a new University of California, San Francisco (UCSF) study. 

Dementia patients wind up in emergency rooms in the US 73 percent more frequently when their caregivers are depressed, according to a new UC San Francisco study

‘When caregivers lack the outpatient support or emotional reserve to face the progressively challenging needs of the patient with dementia, the [emergency department] may present a practical source of health care,’ the study authors wrote. 

But that, they argue, begins a vicious cycle for caregivers, their loved ones and the American medical system. 

The work that caregivers put into looking after their ailing loved ones is valued at nearly $234 billion by the Alzheimer’s Association. 

Plus, the organization predicts that medical care for dementia patients will cost the US $290 billion. 

Scheduled appointments with primary care physicians and specialists are costly enough, but emergency room visits – particularly those that prove unnecessary – are even more expensive.   

In 2017, the average ER visit cost a whopping $1,389. 

According to prior research, between 30 and 80 percent of dementia sufferers make at least one trip a year to the ER. 

Although medical professionals can offer treatments and expertise that caregivers simply can’t, they’re also uniquely dangerous places for dementia patients. 

Previous studies have found that dementia patients are at a two-fold greater risk of developing complications while in the hospital compared to patients with fully intact cognitive function. 

Among these complications is delirium, a state of intense confusion and disorientation. 

Some studies suggest that as much as 50 percent of patients that develop delirium die in the following six months. 

The health risks to the patients as well as the additional financial burden placed on their caregivers underscore the importance of keeping dementia patients out of the hospital as much as possible, and that requires assessing the risk factors. 

In addition to the patients’ own health, the mental health of the caregiver may weigh heavily on the odds that a dementia patient goes to the ER. 

The UCSF study, published in JAMA Neurology, assessed 663 pairs of dementia patients and caregivers. 

Just under 13 percent of the caregivers were suffering from depression, and over half (55.5 percent) felt that caring for their elderly loved ones was a considerable burden, financially and otherwise.  

Those dementia patients whose caregivers were depressed wound up in ERs 73 percent more frequently, raising their risks for complications and delirium and piling more financial worry onto their already stressed caregivers. 

‘By overlooking caregiver depression in our clinical encounters, we may be neglecting an important component of care and limiting our ability to maximize patient outcomes,’ the study authors wrote. 

‘The next challenge will be determining whether interventions that decrease caregiver depression can result in better health and lower costs for patients and caregivers alike.’ 

Currently, there are limited options for burned out and depressed caregivers. 

Respite centers and adult day cares may offer a break, but they are only covered by Medicaid for the lowest income families, and not in every community, though some may offer sliding scale pricing. 

If this is unaffordable, caregivers don’t have many places to turn for a break, but can find some outlet through in-person and online support groups or counseling services. 

In desperation, they may turn to hospital visits as a respite, but, as the new study suggests, that may only start the cycle anew and add stress and financial burden to an already difficult predicament.