January 21, 2016
By Tom Canty, Vice President and General Manager, Empire BlueCross BlueShield Government, Labor and 
Special Account
In September 2014, President Obama announced a $100 million federal brain initiative to revolutionize our understanding of the human mind and uncover new ways to treat, prevent and cure brain disorders. In time, this unique public-private sector initiative will hopefully yield new ways to manage Alzheimer’s disease, dementia and other related conditions.
While we await these scientific breakthroughs, 5.2 million Americans suffer from the physical and psychiatric symptoms of dementia. According to the Alzheimer’s Association, the disease accounts for $604 billion in spending annually. Much of this is passed through Medicare, since the disease impacts mostly older adults. In fact, nearly one of every five Medicare dollars is spent helping people with dementia.
There’s a human cost, too. People with brain disease often suffer from profound feelings of loneliness, isolation and hopelessness as they and their families progress through a disjointed health care system.
A brain health program designed to fill these gaps identified best practices for caring for people with brain health issues. While this is admittedly just the beginning, we hope the following tips make life a little easier for people with dementia and their loved ones.
· Identify dementia symptoms as early as possible.Unfortunately, there is no single test to determine if someone has dementia, which can be frustrating to both patients and their caregivers. Before receiving a diagnosis, people may seek treatments that are unnecessary, disruptive, costly and perhaps painful. Even when dementia is eventually identified as the likely outcome through a variety of tools, the diagnosis may be difficult to accept. That’s unfortunate since early diagnosis can help all of those involved make better health care decisions. Most importantly, an early diagnosis allows patients to clearly communicatetheir wishes while they are still able to do so, alleviating fear and stress for both the person living with dementia and their caregivers. The Alzheimer’s Association (www.alz.org) offers some great tools to identify the warning signs of the disease, to plan for the future and more.
· Establish a multidisciplinary treatment team and a plan. Dementia is a complex disease. Treating it effectively requires a multidisciplinary team with a broad skillset, including doctors, pharmacists, nutritionists and social workers, to name a few. This team can be designed to address all of a patient’s needs, both clinical and non-clinical. One expert, for example, might make sure a patient’s home is clear of clutter that may cause falls. Another may help prepare important legal documents, such as designating a health care surrogate who will make health care decisions when a patient cannot. This naturally leads us to our final tip regarding the components of a successful brain health program.
· Engage caregivers in their loved one’s treatment. According to the Alzheimer’s Association 2014 Alzheimer’s Disease Facts and Figures report, 15.5 million caregivers provided an estimated 17.7 billion hours of unpaid care for people with dementia in 2013 valued at more than $220 billion.[iii] These caregivers are often called upon to make decisions that their loved ones cannot late in the disease. However, they may lack the information they need to make informed decisions. For that reason, it is critical for the care team to include the caregiver in the patient’s treatment plan. By learning about dementia, a caregiver can better understand how the disease is impacting a loved one and anticipate changes to come as the disease progresses. Once again, the Alzheimer’s Association is good resource here, providing tips on what to expect in the various stages of the disease.
Over time, much needed scientific breakthroughs will enable us to identify and treat patients with dementia and other forms of cognitive decline in ways we never imagined before. Until that day arrives, we need better systems of care that address the holistic needs of patients and their families, incorporating tips like those I’ve mentioned above.
