Long-term care eligibility criteria for people with Alzheimer's disease

Abstract

Long-term care (LTC) eligibility criteria are applied to a sample of 8,437 people with dementia enrolled in the Medicare Alzheimer's Disease Demonstration. The authors find that mental-status-test cutoff points substantially affect the pool of potential beneficiaries. Functional criteria alone leave out people with relatively severe dementia and with behavioral problems. It is therefore important to consider both behavioral and mental-status-test criteria in establishing eligibility for community-based services for people with dementia.

Figure 1. Proportion of the Sample Eligible for Long-Term Care Using Different ADL Criteria

Figure 2. Proportion of the Sample Eligible Using Combined MMSE/ADL Criteria

Figure 3. Proportion of the Sample with Health and Safety-Related Behavioral Problems Ineligible for Long-Term Care Using ADL Criteria Alone

Figure 4. Relationship Between Caregiver Hours and Need for ADL Assistance