How Michigan can prepare for the coming Alzheimer’s crisis

Alzheimer's patient

Several states have passed legislation that offers or requires training to detect and help patients showing signs of Alzheimer’s disease or other forms of dementia.

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Michigan’s graying population is rapidly leading to a crisis in care for the state’s Alzheimer’s population, a trend expected to accelerate over the next years and decades. 

With associated costs of care estimated to rise above $15 billion annually, Michigan leaders and advocates face a host of challenges planning for the disease, and its impact on patients, caregivers and scarce medical resources.   

Related: Alzheimer's in Michigan: The coming storm

Here are some possible policy options for the state to consider: 

Add more geriatric specialists

Michigan is expected to need 892 certified physician geriatric specialists by 2030. As of 2014, there were just 222 such specialists in the state.

Michigan’s Department of Health and Human Services offers loan forgiveness for geriatricians, as well as family practice physicians, psychiatrists and other health care practitioners who locate in underserved areas.

But open geriatric fellow positions go unfilled across the nation, in part because salaries for geriatricians significantly lag those for other specialties like orthopedics or cardiology.

Require training for doctors 

Massachusetts enacted a law in 2018 that requires all doctors, physician's assistants and nurses who serve adults to complete a one-time training on the diagnosis, treatment and care of people with Alzheimer's. Protective service caseworkers who work with seniors are also to be trained on how to recognize Alzheimer's. Virginia passed a law requiring training for health-care providers on early detection and diagnosis. Oregon passed a similar measure for staff at residential care facilities. 

Training for caregivers, first responders

According to a May report by the Michigan Dementia Coalition, a collection of organizations including healthcare systems, universities, state agencies, service providers and others, 12 of the state’s 16 Area Agencies on Aging provide six-week training to family caregivers for people with dementia living at home. That could be expanded to include caregivers in the entire state.

Connecticut passed a 2014 law that requires dementia training for emergency first responders, but also for probate judges, conservators and protective service personnel. In other words, for a range of professionals who can have a profound impact on the lives and care of vulnerable adults.  

Expand paid sick leave

Paid sick leave took effect in Michigan in March, a measure that applies to companies with more than 50 employees and limits leave to 40 hours in one year.

Seven states – California, New Jersey, Rhode Island, New York, Washington State, Connecticut and Massachusetts – have enacted expanded family sick leave measures that provide paid leave ranging from four to 12 weeks.

But extended leave is an option Michigan’s Republican-majority Legislature rejected in last December’s lame-duck session, when it reduced leave benefits passed earlier in the session. 

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Comments

Robert Raible
Mon, 07/29/2019 - 8:47am

I'm trying to share this on Twitter, but the share link doesn't work.

Rl>
Mon, 07/29/2019 - 8:47am

Hopefully you will never be confronted with this terrible disease. It can truly be the Long Goodbye" Love those you are with while you still have them. Thankyou for shedding light on this illness. peace R.L.

Scott Roelofs (...
Mon, 07/29/2019 - 12:14pm

Perhaps the state should adopt a "nursing care for all" plan, similar to "Medicare for All" that is being pushed at the federal level. $6,500 per month for a nursing home providing dementia care will bankrupt most Michigan families. Unfortunately, Michigan government cannot go into debt like the federal government can. So taxes will have to cover it. Look at the successful unlimited life-time care benefits in auto insurance: only a few hundred dollars per year per auto policy covers it.
Michigan could provide free nursing-home care for all, by raising the income tax from 4% to about 8%. An alternative public policy would be to leave the income tax rate at 4% for most people, but raise it to 10-15% for taxpayers over age 55. Many retirees would likely move to Florida where the income tax is zero. But that could be a partial solution to the impending crisis.

K Hogan
Mon, 07/29/2019 - 3:04pm

Or you could just have us euthanized. That would solve the problem and beginning to look like what is in the works. Reap what you sow.

R.L.
Mon, 07/29/2019 - 3:36pm

Two years ago it was $8620 per month for my father in laws nursing home car. And oh yes we did his laundry to keep the cost down. And oh yes that was two to a room and 4 to share a bath room. I believe now it is right around$9,000 Peace R.L.

Margene Scott
Tue, 08/06/2019 - 12:16am

Would like some guidance or training in how to be a caregiver for a spouse with dementia.