title: Cruise ship care: a proposed alternative to assisted living facilities.
abstract: Options for elderly patients who can no longer remain independent are limited. Most choices involve assisted living facilities, 24-hour caregivers, or nursing homes. State and federal assistance for payment for individual care is limited, and seniors usually pay for most costs out of pocket. For those patients who have the means to afford assisted living centers or nursing homes, "cruise ship care" is proposed. Traveling alongside traditional tourists, groups of seniors would live on cruise ships for extended periods of time. Cruise ships are similar to assisted living centers in the amenities provided, costs per month, and many other areas. This article begins with an examination of the needs of seniors in assisted living facilities and then explores the feasibility of cruise ship care in answering those needs. Similarities between cruise ship travel and assisted living care, as well as the monetary costs of both options, are defined. A decision tree with selections for non-independent care for seniors was created including cruise ship care as an alternative. Using a Markov model over 20 years, a representative cost-effectiveness analysis was performed that showed that cruises were priced similarly to assisted living centers and were more efficacious. Proposed ways that cruise ship companies could further accommodate the needs of seniors interested in this option are also suggested. Implementation for cruise ship care on the individual basis is also presented. Ultimately, it is wished to introduce a feasible and possibly more desirable option to seniors who can no longer remain independent.
authors.affiliation: Divisions of Internal and Geriatric Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Chicago, IL 60611, USA. LAL425@md.northwestern.edu
authors.forename: Lee A
authors.initials: LA
authors.lastname: Lindquist
authors.forename: Robert M
authors.initials: RM
authors.lastname: Golub
mesh_terms: D000368:Aged; D040561:Assisted Living Facilities / Q000379:methods*; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D006801:Humans; D008390:Markov Chains; D012767:Ships