Alzheimer’s and related dementias affect millions of Americans, with Alzheimer’s disease alone impacting 5.7 million people in 2018. By 2050, this number is projected to rise to nearly 14 million, with someone in the U.S. developing the disease every 65 seconds. It’s the sixth-leading cause of death in the U.S., killing more people than breast cancer and prostate cancer combined. While deaths from heart disease have decreased 11 percent between the years 2000 and 2015, deaths attributable to Alzheimer’s disease have increased 123 percent. One in three seniors nationally will die with Alzheimer’s or another dementia.
Although many people with Alzheimer’s disease reside at home with a caregiver (family member or other), more are residing in post-acute settings such as skilled nursing centers. Fifty percent of skilled nursing center residents in 2014 had Alzheimer’s or other dementias, and 61 percent had moderate or severe cognitive impairment. Nursing home admission by age 80 is expected for 75 percent of people with Alzheimer’s, compared with only 4 percent of the general population. Persons with Alzheimer’s also have more hospitalizations, and at a higher average cost to the Medicare system. In fact, the estimated lifetime cost of care for an individual living with dementia is $341,840.
These statistics, as alarming as they may seem, are amplified when combined with the nation’s workforce issues. The nation’s skilled nursing centers are collectively dealing with challenges in recruiting and retaining quality staff, which can negatively affect care delivery. However, providers are finding ways to deliver on their commitment to quality care through improvements in organizational culture, along with innovative methods for staffing such as the neighborhood model and versatile workers.
Staff education is a critical piece to both retention and compassionate care of elders with dementia. As noted above, the percentage of people with Alzheimer’s disease as a total of the population residing in skilled nursing centers continues to increase, which requires that staff are properly trained on the disease process, its stages and the issues that can accompany the disease, e.g., agitation, problems sleeping, getting up and wandering and occasional violent outbursts. While people exhibiting these kinds of behaviors have historically been treated with antipsychotic drugs, there is increasing pressure to find more person-centered interventions that don’t require medications. These interventions require well-trained staff who are familiar with these nonpharmacological approaches and are trained in how and when to use them.
The bottom line to quality dementia care is the individual—the individual with the disease and the individual providing the care. By keeping the focus on the individual, care for those affected by Alzheimer’s disease is more likely to improve, because the staff providing the care are more knowledgeable of that person’s needs, preferences, dislikes and history.
When the focus is on the individual, compassionate care—not just minimal care—is the result. Care is at the heart of your mission and your nurses know too well the struggles of preserving a culture committed to caregivers. It isn’t just about staffing—it’s about supporting.
For more information and resources on caregiving and dementia, contact Bob or your trusted BKD advisor.