The report describes the results of an economic analysis of the first four sites in the HSE & Genio Dementia Programme. The objective of the current study is to provide an economic analysis of the cost of care for people with dementia on the boundary between home care and residential care within the innovative HSE & Genio Dementia Programme. A cohort of people with dementia were identified who were living at home, but were at significant risk of admission to residential care in the medium term. By concentrating on the margin between community and residential care, it may be possible to provide some insight into the benefits of investing in personalised community-based supports for this group rather than the alternative of admission into long-stay care.

The following key points emerged from the report:

• Significant numbers of people with dementia could potentially be supported to live at home for longer as a result of the HSE & Genio Dementia Programme, thus resulting in savings to the exchequer when comparisons are made between public expenditure in the community and in residential care.
• Almost a third (32%) of the 568 people with dementia in the study were judged to be on this boundary and their care in the community cost significantly less than care in a residential setting. 
• The social cost of community based care on carers must be acknowledged and greater supports for informal carers should be provided.
• For a relatively small investment in innovative, personalised supports, lives can be transformed and residential costs postponed.
• While the analysis is focused on actual provision rather than optimal provision, the study provides valuable insight into resource use and costs of community-based care at the boundary between community and residential care.
• Local context plays a key role in shaping opportunities to age at home, particularly the willingness and ability of local government to reconfigure resources towards community-based care at earlier stages.