Researchers Target Avoidable Hospitalizations for Dementia Patients in Nursing Homes

In the United States, the prevalence of Alzheimer's disease and related dementias is escalating at an alarming rate. As of 2025, approximately 7.2 million Americans aged 65 and older are projected to be living with Alzheimer's, marking a significant increase from previous years.

This surge presents profound challenges, particularly concerning the provision of long-term care. Notably, 56% of adults aged 65 and older will require long-term care at some point in their lives, with an average duration of 3.2 years. Over 20% of these individuals may need care for five years or longer.

Despite the growing demand, Medicare and health insurance plans do not cover non-medical long-term care services, such as assistance with daily activities. Medicare typically covers only short-term skilled care, leaving many families to shoulder the financial burden of extended care.

Only Long-Term Care Insurance and Medicaid, for those with limited financial resources, will pay for all levels and types of long-term care, including dementia care.

Reducing Stressful and Costly Hospital Transfers

In response to these challenges, researchers at the University of Missouri are striving to reduce avoidable hospitalizations among nursing home residents with dementia. Their study, "Untangling the complex web of avoidable nursing home-to-hospital transfers of residents with dementia," published in Alzheimer's & Dementia, highlights the complexities of decision-making processes regarding hospital transfers for cognitively impaired residents.

Kimberly Powell, an assistant professor at the Sinclair School of Nursing, led the study and found that residents with Alzheimer's or related dementias are more likely to experience avoidable hospital transfers compared to those without dementia. These transfers often result from a mismatch between the care provided and the resident's personal preferences.

Powell emphasizes the importance of early and ongoing advanced care planning, especially for residents in the earlier stages of disease progression who can better communicate their desires and values.

Having those conversations early and often—ideally when a resident might be in an earlier stage of disease progression and better able to communicate their desires and values—helps us honor them through the rest of their life.

Powell said that those with a progressive disease like Alzheimer's or dementia often find that they value having dignity later in life and being in a place that is comfortable while surrounded by people they know and love.

We also found that increasing nursing home staff support, training and resources can help residents receive the care they need as they age while remaining in the nursing home. We ultimately want to better support the staff who work in nursing homes.

The study also underscores the need for increased support, training, and resources for nursing home staff to ensure residents receive appropriate care within the facility, aligning with their preferences and reducing unnecessary hospitalizations.

Impact of Miscommunication and Pain Management

Ashley Woods, a doctoral student at the Sinclair School of Nursing and a nurse practitioner in New Mexico, notes that there is often a disconnect between documented care preferences and the actions taken during episodes of agitation or other symptoms in residents with dementia.

She highlights the trauma and stress that unnecessary hospital transfers can cause, which often do not align with the priorities and goals of the patient.

Those with dementia may experience a temporary episode of agitation in the nursing home, but by the time I see them in the hospital, everything looks good. Still, the transfers are often a traumatic and stressful experience for the residents and they don't often align with the priorities and goals of the patient.

Woods' research further explores how frequently nursing home care teams address pain in residents with dementia, aiming to improve care strategies and outcomes for this vulnerable population.

Financial Burdens and Long-Term Care Gaps

The findings from this research are particularly pertinent given the projected increase in dementia cases and the existing gaps in long-term care coverage. Families often bear significant financial and emotional burdens with Medicare and most health insurance plans not covering non-medical long-term care.

The total lifetime cost of care for someone with dementia is estimated at nearly $400,000. According to an LTC News survey of long-term care costs nationwide, memory care in a facility is costly. Memory care costs over $5800 a month before surcharges, and nursing homes average over $9700 a month.

The cost of long-term care services varies depending on the levels and type of services provided and your location.

Furthermore, the demand for direct care workers is rising. Between 2012 and 2022, the number of direct care workers increased from 3.2 million to 4.8 million, yet more than 1 million additional workers are needed to meet the growing demand for long-term care services.

A Call for Better Support and Policy Reforms

The University of Missouri's research highlights the critical need for comprehensive care planning, enhanced support for nursing home staff, and policy reforms to address the financial and logistical challenges of long-term care for individuals with dementia.

Many people are unaware of the Long-Term Care Insurance Partnership Program that most states participate in. The program provides policyholders with additional dollar-for-dollar asset protection. In addition, there are federal and state tax incentives for LTC Insurance that may be available for some policyholders.

By planning ahead and prioritizing care that aligns with residents' preferences while minimizing unnecessary hospitalizations, you can enhance the quality of life for nursing home residents with dementia and help ease the strain on the healthcare system.

However, the quality of long-term care can vary significantly, and finding suitable memory care can be a difficult task for many families. The LTC News Caregiver Directory simplifies this process by allowing you to search through a nationwide network of over 80,000 providers.

If your loved one has an LTC policy, be sure to seek benefits from it without delay. LTC NEWS has combined efforts with Amada Senior Care, a leading in-home healthcare agency with locations throughout the country, to help you process a claim from any LTC Insurance policy. 

There is no cost or obligation for this service - Filing a Long-Term Care Insurance Claim.