Willingness of families caring for victims of dementia to pay for nursing home care: results of a pilot study in Taiwan.

In order to examine the value family caregivers attach to the benefits associated with nursing home services, this contingent survey was designed to investigate the willingness of family caregivers of dementia victims to pay for nursing home care. A total of 136 members of families of dementia patients from the department of neurology and psychiatry of four medical centers in Taiwan were interviewed by phone. These family members provided in-home care for dementia victims and had expressed the need for nursing home placement. These family caregivers were asked to explicitly state the maximum amount of family income per month they are able to give up to receive nursing home services. The willingness to pay (WTP) for nursing home care ranged from US$185 to $2,407 per month, and 37.5 percent of the family caregivers interviewed indicated a willingness to pay at least 50 percent of the monthly family income for nursing home placement. The amount of monthly family income was strongly associated with the WTP for nursing home care in dollars. Age and education of the caregiver, and accessibility of nursing home care were significantly associated with WTP in both cost range and percentage of monthly family income. Interviewees who were older than 65 years (odds ratio is 3.52), and educated equal to or above senior high school (odds ratio is 5.57) were inclined to pay at least 50 percent of monthly family income for nursing home placement. As other variables were adjusted, respondents older than 65 years were willing to pay US$208.4 per month more than those younger than 65 years for nursing home placement; and the educated equal to or above senior high school were inclined to pay US$171.9 per month more than those with less than a senior high school education. The easier it was to find nursing home agencies near the residence, the more willing the family was to pay at least 50 percent of their monthly family income for nursing home services; with an odds ratio of 16.51. The families with the higher accessibility to nursing home agencies were willing to pay US$174.3 per month more than caregivers with lower accessibility. Family caregivers, who were older than 65 years, educated above the senior high school level, with a higher family income, and easier accessibility to nursing home services, were likely to attach higher economic values to nursing home placement.