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Elderly People with Advanced Cognitive Impairment in England: Resource Use and Costs

Published online by Cambridge University Press:  14 November 2008

Justine Schneider ,
Shane Kavanagh ,
Martin Knapp ,
Jeni Beecham  and
Ann Netten
Justine Schneider
Affiliation:
The authors are all members of Personal Social Services Research Unit, The University, Canterbury, Kent CT2 7NF, U.K.
Shane Kavanagh
Affiliation:
The authors are all members of Personal Social Services Research Unit, The University, Canterbury, Kent CT2 7NF, U.K.
Martin Knapp
Affiliation:
The authors are all members of Personal Social Services Research Unit, The University, Canterbury, Kent CT2 7NF, U.K.
Jeni Beecham
Affiliation:
The authors are all members of Personal Social Services Research Unit, The University, Canterbury, Kent CT2 7NF, U.K.
Ann Netten
Affiliation:
The authors are all members of Personal Social Services Research Unit, The University, Canterbury, Kent CT2 7NF, U.K.
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Abstract

This paper describes where elderly people with moderate to severe (‘advanced’) cognitive impairment are living, what resources they use and the costs of these services to different funding agencies. It operationally defines dementia in terms of cognitive impairment and uses the OPCS disability surveys to estimate the prevalence of moderate to severe cognitive impairment in England. The paper goes on to describe services received by this client group on the basis of the same surveys, and costs these by supplementing the data with information from related studies by the PSSRU. Since accommodation is a major cost, the population of elderly people with cognitive impairment is classified according to their place of residence. Thus we are able to estimate the ‘baseline’ global cost of provision for this client group at current prices. We make cost projections at 1991/92 price levels to the national level, and discuss the implications in terms of burdens to different agencies.

Type
Research Article
Information
Ageing & Society , Volume 13 , Issue 1 , March 1993 , pp. 27 - 50
Copyright
Copyright © Cambridge University Press 1993

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References

American Psychiatric Association 1987. Diagnostic and Statistical Manual of Mental Disorders, third edition (revised). APA, Washington, D.C.Google Scholar
Arber, S. and Ginn, J. 1990. The meaning of informal care: gender and the contribution of elderly people. Ageing and Society, 10, 429–454.CrossRefGoogle Scholar
Avebury, K. 1984. Home Life, A Code of Practice for Residential Care. Centre for Policy on Ageing.Google Scholar
Beecham, J. and Knapp, M. 1991. Costing Psychiatric Interventions, filed as Discussion Paper 744. Personal Social Services Research Unit, University of Kent at Canterbury.Google Scholar
Bowling, A. and Farquhar, M. 1991. Psychiatric morbidity and service use among elderly people. Ageing and Society, II, 275–297.CrossRefGoogle Scholar
Brayne, C. 1990. The case identification of dementia in the community: a comparison of methods. International Journal of Geriatric Psychiatry, 5, 309–316.CrossRefGoogle Scholar
Brayne, C. and Calloway, P. 1989. An epidemiological study of dementia in a rural population of elderly women. British Journal of Psychiatry, 155, 214–219.CrossRefGoogle Scholar
Brodaty, H. and Hadzi-Pavlovic, D. 1990. Psychosocial effects on carers living with persons with dementia. Australia and New Zealand Journal of Psychiatry, 24, 1375–1379.CrossRefGoogle ScholarPubMed
Central Statistical Office 1992. Social Trends 22, H.M.S.O.Google Scholar
Challis, D. and Davies, B. 1986. Case Management in Community Care. Gower, Aldershot.Google Scholar
Challis, D., Darton, R., Johnson, L., Stone, M., Traske, K., and Wall, B. 1991. The Darlington Community Care Project: Supporting Frail Elderly People at Home, Personal Social Services Research Unit, University of Kent at Canterbury.Google Scholar
Clark, M., Lowry, R. and Clarke, S. 1986. Cognitive impairment in the elderly – a community survey. Age and Ageing, 15, 278–284.CrossRefGoogle Scholar
Copeland, J., Dewey, M. and Griffiths-Jones, H. 1986. Computerised psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychological Medicine, 16, 89–99.CrossRefGoogle ScholarPubMed
Darton, R. and Knapp, M. 1984. The cost of residential care for the elderly: the effects of dependency, design and social environment. Ageing and Society, 4, 157–183.Google Scholar
Davies, B., Bebbington, A., Charnley, H. and colleagues 1990. Resources Needs and Outcomes in Community Care. Avebury, Aldershot.Google Scholar
Davies, B. and Challis, D. 1986. Matching Resources to Needs in Community Care. Gower, Aldershot.Google Scholar
Department of Health 1991. Memorandum laid before the Health Committee, House of Commons paper no. 408. HMSO, London.Google Scholar
Derbyshire, M. E. 1987. Statistical rationale for grant-related expenditure assessment (GREA concerning Personal Social Services. Journal of the Royal Statistical Society, 150, 309–333.Google Scholar
Graham, N. 1991. The practical management of dementia. Geriatric Medicine, (06 1991). 37–40.Google Scholar
Greene, J. G., Smith, R., Gardiner, M. and Timbury, G. C. 1982. Measuring behavioural disturbance of elderly demented patients in the community and the effect on relatives: a factor analytic study. Age and Ageing, II, 121–126.CrossRefGoogle Scholar
Gurland, B., Copeland, J., Kelleher, M., Kuriansky, J., Sharpe, L. and Dean, L. 1983. The Mind and Mood of Ageing: Mental Health Problems of the Community Elderly in London and New York, Groom, Helm, London.Google Scholar
Health Advisory Service 1982. The Rising Tide: Developing Services for Mental Illness in Old Age. HAS, Sutton.Google Scholar
Hofman, A., Rocca, W., Brayne, C., Breteler, M., Clarke, M., Cooper, B., Copeland, J., Dartiques, J., da Silva Droux, A., Hagnell, O., Heeren, T., Engedal, K., Jonker, C., Lindsay, J., Lobo, A., Mann, A., Molsa, P., Morgan, K., O'Connor, D., Sulkava, R., Kay, D. and Amaducci, L. 1991. The prevalence of dementia in europe: a collaborative study. International Journal of Epidemiology, 20, 736–745.CrossRefGoogle ScholarPubMed
Knapp, M., Cambridge, P., Thomason, C., Beecham, J., Allen, C. and Darton, R. 1992. Care in the Community: Challenge and Demonstration, Ashgate, Aldershot.Google Scholar
Laing & Buisson 1991. Care of Elderly People: Market Survey 1990/91. Laing & Buisson, London.Google Scholar
Levin, E., Sinclair, I. and Gorbach, P. 1988. The effectiveness of the home help service with confused old people and their families. Research Policy and Planning, 3, 1–7.Google Scholar
Levin, E., Sinclair, I. and Gorbach, P. 1989. Families, Services and Confusion in Old Age. Avebury, Aldershot.Google Scholar
Levin, E., Moriarty, J. and Gorbach, P. (1992) “I couldn't manage without the breaks.” Report to Department of Health. National Institute of Social Work, London.Google Scholar
Livingston, G., Hawkins, A., Graham, N., Blizard, , and Mann, A. (1990). Gospel Oak Study: prevalence rates of dementia, depression and activity limitation among elderly residents in inner London. Psychological Medicine, 20, 137–146.CrossRefGoogle ScholarPubMed
Martin, J., Meltzer, H. and Eliot, D. 1988. Report I – The Prevalence of Disability Among Adults. Office of Population Censuses and Surveys, Social Survey Division, HMSO, London.Google Scholar
Maule, M. M., Milne, J. S. and Williamson, J. 1984. Mental illness and physical health in older people. Age and Ageing, 13, 239–256.CrossRefGoogle ScholarPubMed
Melzer, D. 1990. An evaluation of a respite care unit for elderly people with dementia: framework and some results. Health Trends, 2, 64–67.Google Scholar
Melzer, D., Hopkins, S., Pencheon, D., Brayne, C. and Williams, R. 1992. Epidemiologically Based Needs Assessment of Services for People with Dementia. Report to Department of Health, provisional version 03 1992.Google Scholar
Netten, A. 1990. An Approach to Costing Informal Care, Discussion Paper No. 637. PSSRU, University of Kent.Google Scholar
Netten, A. 1992a. Some cost implications of Caring for People, filed as Discussion Paper 809/3. PSSRU, University of Kent.Google Scholar
Netten, A. 1992b. A Positive Environment? Ashgate, forthcoming.Google Scholar
O'Connor, D. W., Pollitt, P. A., Brook, C. P. B., Reiss, B. B. and Roth, M. 1991. Does early intervention reduce the number of elderly people with dementia admitted to institutions? British Medical Journal, 302, 871–874.Google Scholar
Royal College of Physicians 1981. Organic mental impairment in the elderly. Journal of the Royal College of Physicians, London, 15, 141–167.Google Scholar
Secretaries of State for Health 1989. Working for Patients. HMSO, London.Google Scholar
Secretaries of State for Health 1989. Caring for People, Cmnd 849, HMSO, London.Google Scholar
Spoor, C. 1988. Care of the Elderly with Psychiatric Disorders, Soap No. 11. Health Economics Research Unit, 08 1988.Google Scholar
Tinker, A. 1989. An Evaluation of Very Sheltered Housing. Department of the Environment. London: H.M.S.O.Google Scholar
Wagner, G. 1988. Residential Care: A Positive Choice. Report of the Independent Review of Residential Care, National Institute of Social Work/HMSO, London.Google Scholar
Tolley, K. and Wright, K. 1989. The Costs of Services for Elderly Mentally Disordered People at Home, Inspection of Community Social Services for Elderly People with Mental Disorder, 87–107. Department of Health/Social Services Inspectorate, London.Google Scholar