**4.3 Estimated monetary costs**

The results concerning the costs and monetary values relatively to the informal caregivers are expressive and informative for policymakers. From the point of view of the cost with health care supported by caregivers, data shows that the total amount spent annually is almost 590€ or almost 50€ a month. These costs are reported by caregivers (**Table 1**).

From the different activities performed by caregivers for their patients, data obtained from the questionnaire unveil that the activities that absorb the highest share of daily hours are the activities of daily living (ADL), such as toilet visits, eating, dressing, grooming, walking and bathing, and the instrumental activities of daily living (IADL), such as shopping, food preparation, housekeeping, laundry, transportation, taking medication and managing financial matters and supervision (**Figure 6**).

Finally, according to hours of care provided for the Alzheimer's patient, the total average annual monetary value of those hours may be estimated. Taking into account the average number of daily hours of care and the monetary value of each hour (the value is estimated using the proxy-good method), the total average annual value of care sums up to 14,152.32 euros (**Table 2**). The values may vary according to the level of severity of the disease. At the most severe level of severity, these values decrease because there is an increasing share of burden with formal care.


#### **Table 1.**

*Annual average costs supported by informal carers.*

#### **Figure 6.**

*Distribution of daily hours across activities. Source: Freitas [20].*


#### **Table 2.**

*Monetary value for care given by the informal carer.*

Summing up, the burden taken by an Alzheimer's patient caregiver includes the costs related to labour absence, to the lack of social activities and to health deterioration which may be reflected in health-care costs or untreated health conditions. These health-care costs were valued by 586.44€ average a year, even though caregivers seldom find time to look after themselves.

On the other hand, the caregivers provide care which was estimated to value over an average of 14,100€ per year, mainly resulting from daily activities and supervision activities. However, these values may be underestimated. On the one hand, caregivers tend to under-report the time spent providing care; on the other hand, the proxy-good method does not account for all cost, and it undervalues some activities, because they are associated with low labour market qualifications.
