Dementia is a challenging and often painful journey not just for people suffering from it but also for their family and friends. Providing optimal long-term support is the only way to ease the burden of this condition for all those involved. A new RAND Corporation study stresses the need for dementia related long-term services and support (LTSS) by outlining policy options centered around five major tasks.

According to RAND, 15 percent of Americans older than age 70 had some form of dementia, like Alzheimer’s, in 2010. The number of new dementia cases among those 65 and older is expected to triple by the year 2050, too. Meanwhile, the emotional and physical stress that comes with caregiving is especially high. Thirty-three percent of family caregivers said that they were stressed with taking care of a relative with dementia , according to a 2012 report. And the stress mostly resulted from the financial burden of treatment.

RAND researchers estimate the annual costs of dementia care to be between $159 billion and $215 billion, but that amount is expected to double by 2040. Existing national plans or reports have focused on either long-term care or dementia, but the RAND study tries to focus on solutions for both, the researchers said. 

"A recent study by RAND found that the majority of Americans' cost-burden for dementia is caused by long-term care," said Regina A. Shih, the study's lead author and a senior behavioral scientist at RAND, in a press release. "As baby boomers reach the ages of highest dementia risk, the nation faces urgency in finding ways to improve long-term services and supports specifically for this condition. This issue is critical for families and loved ones who provide the bulk of dementia care."

The corporation formulated five objectives, which are the basis for 25 "high-impact" policy optons. They were: 

1. Increase public awareness of dementia to reduce stigma and promote earlier detection: Services cannot be provided unless dementia is recognized. Hence, improved cognitive-assessment tools have to be developed to effectively screen for possible dementia.

2. Improve access to and use of LTSS, promoting high-quality, person- and caregiver-centered care: A substantial number of dementia patients use home- and community-based services. Improving these services, as well as incentivizing caregivers, broadening Medicaid waiver programs, and refining Medicare- and state-funded home and community-based services are some of the goals related to this.

3. Promote high-quality care that is focused on the needs of the individual and family caregivers: Better logistical support to home- and community-based services, which help dementia patients return to their community. Hospice caregivers could also used better training.

4. Provide better support for family caregivers of people with dementia-Providing information that will help care-givers identify, choose, and obtain services provided by different institutions and to provide financial assistance for the caregivers are covered in this task.

5. Reduce the burden of dementia LTSS costs on individuals and families: This includes linking private long-term care (LTC) insurance to health insurance, and creating a single-payer life insurance system.

These objectives can only be accomplished through transparency and cooperation between policy makers, healthcare providers, and researchers, the corporation said. "There is no one single path that is the best one to follow to provide better care for people with dementia and improve support for their caregivers," Shih said. "But what is clearly needed is more and quicker action around a set of recommendations to respond to this large and growing problem." 

With these objectives, RAND researchers hope to increase awareness to promote early and better diagnosis; to improve facilities and long-term care for patients and caregivers through different forms of treatment; and to ease the financial burden for middle- and low-income families with better benefits.

 

 

Source-Shih R, Concannon T, Liu J and Friedman E, Improving Dementia Long-Term Care: A Policy Blueprint, Rand, 2014.