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Individuals with Dementia:

Long-Term Care Policy Challenges

Matthew Baumgart

Senior Director, Public PolicyAlzheimer’s Association

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Some Basics

Not just a

“little memory

loss” – and not a normal part of aging

Progressive disease that

destroys brain cells,

causing problems

with memory, thinking,

and behavior

Eventually, takes away ability to

communicate, move, and

swallow

Ultimately, fatal

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Some Facts

5.2200,000Million

1 in 9 Americans Aged 65 and Over

1 in 3

85 +

2 in 3Half

Don’t Know

6th

Americans living with Alzheimer’s disease

leading cause of death in America

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Some Arkansas Facts

60,000

Arkansans living with Alzheimer’s disease

122%

increase in number of deaths between 2000-

2010

20%

percentage of 60+ with worsening memory

problems

81%

have not talked to a health care provider

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in costs to American society of caring for

individuals with Alzheimer’s disease

Billion$203

“skyrocketing at a rate that rarely occurs with a chronic disease”

--New York Times

of AD life spent in most severe stage

The Costs $107BMedicare

$35BMedicaid

$34BOut of Pocket

$27BOther

Average Per SeniorMedicaid Spending

W/O AD/D $549

W/ AD/D $10,538

19XHIGHERWHY?

40%

In Nursing Home by 80 75%Senior Residents w/ AD 65%

People with Alzheimer’s more likely to be on Medicaid

Without AD/D 11%With AD/D 29%AD Medicaid Residents 51%

People with Alzheimer’s more likely to be in nursing homes

“the most expensive malady in the U.S.” --Associated Press

“exceeding that for heart disease and cancer” --Bloomberg News

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The Caregivers

15.4Million

17.5Billion

$216.4Billionunpaid caregivers

value of unpaid care

hours of unpaid care

172Thousand

196Million

$2.4Billion

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Living Alone

800Thousand

live alone

25% of those in the community 31.7%

with worsening memory problems

who live alone

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If you are talking about long-term care, you are

talking about people with dementia.

Improving the long-term care system is crucial for

people with dementia.

BUT

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24.7%

-13.2%

-34.4%

9.2%

Valuing people with dementia and those who care for themTreating people as IndividualsLooking at the world from the Perspective of the person with dementiaA positive Social environment in which the person living with dementia can experience relative well-being

The Policy Challenges

• Person-centered care

BUT

• More home- and community-based services

BUT

• Less restrictive options

BUTChange in Per Capita Senior Health Care Spending, 2004-2008

Seniors without AD/D

HomeCare

NursingHome

HomeCare

NursingHome

Seniors with AD/D

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If you have a system that is

dementia-capable, you have a system that is

capable for all.

Closing Thought