Mary was 86 years old and lived in a large detached house where she had brought up her 3 children. Mary was diagnosed with dementia 5 years ago, and her family who all lived at a distance, had become increasingly concerned that Mary was not able to look after herself. Mary kept getting lost, and her neighbour, Betty was often called to take Mary home. Mary was found near to her house, in the rain without a coat, having fallen and not knowing where she was. She was taken to A&E and spent 2 nights in hospital. After this, Mary’s children decided that Mary needed residential care and a place was found for her, to be paid for by the family using equity from sale of the family house. Mary seemed content in the Care Home, but after a few weeks she became unwell and was admitted to hospital. She was in hospital for 37 days during which time she became increasingly withdrawn and uncooperative. After an assessment in hospital, the care home decided that they were unable to take Mary back and she was discharged to a Specialist Care Home registered for dementia care, again self funded. Her rating on the health, dementia and activity scores had not changed.
Costs of care for 6 months before hospitalisation:
(costed at 21 weeks at home, 5 weeks in residential care)
|Medications @ £11.50 per month||£299|
|2 GP visits @ £120 visit||£240|
|Inpatient 2 nights @ £346||£692|
|A & E, 1 visit||£97|
|Residential care 5 weeks @ £450||£2250|
|Chiropodist, 2 visits @ £28.00||£56.00|
Cost of hospital admission:
|7 days @ £346||£2,422|
|30 days @ £255||£7,650.00|
Mary was discharged to a Specialist Care Home for dementia care. She was seen by her GP once and by a Psychiatrist twice. She was visited regularly in the Care Home by a Mental Health Nurse. She was prescribed memantine, but her condition continued to deteriorate. Her mobility reduced. It became very hard to give her an adequate diet because she had difficulty swallowing, and she became completely uncommunicative. It was a distressing time for the whole family. After 3 months, Mary became severely dehydrated, she was admitted to hospital and after 14 days there, she died.
Costs of Care for 3 months after leaving hospital:
|Medications@ £11.50/ month for 1 month||£11.50|
|Medications@ £87.50/ month for 2 months||£176.00|
|GP visit x 1 @ £120||£120|
|Psychiatrist visit x 2 @ £117||£234|
|Mental Health Nurse visit x 5 @ £56||£280|
|Hospital inpatient, 7 days @ £346||£2,422.00|
|Hospital inpatient, 7 days @ £255||£1,785.00|
|Care Home fee, own contribution, 12 weeks @ £525/ week||£6,300.00|
Costs of care are taken from the Personal Social Services Research Unit Report, 2011, written by the University of Manchester, The University of Kent and the London School of Economics.