Description of Health Issue
Dementia refers to the decline in cognitive abilities, including thinking, remembering, and reasoning, to the point that it disrupts a person’s everyday life and activities. Individuals who have dementia may have difficulty regulating their emotions, leading to potential alterations in their personality (Arvanitakis et al., 2019). Dementia ranges in severity from the earliest stage, when it first begins to affect a person’s abilities, to the most advanced stage, where the individual is entirely reliant on others for fundamental everyday tasks, such as feeding oneself.
Incidence and Prevalence in the US
Dementia has a notable occurrence and prevalence in the United States, with Alzheimer’s disease being the most well-recognized and prevalent kind. According to the given sources, over 7 million individuals in the United States are impacted by Alzheimer’s disease (Alzheimer’s Disease Facts and Figures, n.d.). The majority of individuals in the United States who have Alzheimer’s disease are women, accounting for over two-thirds of cases (Alzheimer’s Disease Facts and Figures, n.d.).
Elderly Black Americans have a far higher likelihood of developing Alzheimer’s disease or other forms of dementia compared to elderly White Americans, with a ratio of almost two to one (Alzheimer’s Disease Facts and Figures, n.d.). Hispanic older adults are 1.5 times more likely to develop Alzheimer’s disease or other types of dementia than their White counterparts (Alzheimer’s Disease Facts and Figures, n.d.). With the aging population, the global prevalence of dementia is expected to rise in the future.
Monitoring and Treatment Strategies
To diagnose dementia, a comprehensive assessment is needed. This includes evaluating the patient’s cognitive decline and impairment in daily activities, with confirmation from a close friend or family member. Additionally, a clinician will conduct a thorough mental status examination to identify impairments in memory, language, attention, visuospatial cognition (such as spatial orientation), executive function, and mood. Short cognitive impairment screening questionnaires may help start and structure the cognitive examination. If the evaluation yields no definite conclusion, such as when symptoms are present, but a physical examination seems normal, neuropsychological testing might assist in making a diagnosis.
A physical examination may help determine the cause of dementia. For instance, the presence of localized neurologic abnormalities indicates the likelihood of a stroke (BĹ‚aszczyk, 2022). Brain scanning may reveal structural alterations such as localized atrophy, infarcts, and tumors that may not be detectable during a physical examination.
For instance, with atypical dementia, it is advisable to do further assessment using cerebrospinal fluid tests or genetic testing. It is particularly important for individuals who develop symptoms before age 65, have a rapid onset, and show impairment across numerous cognitive domains except episodic memory (BĹ‚aszczyk, 2022). Patients may receive effective therapy through non-pharmacologic methods, including engaging in cognitively stimulating activities such as reading, physical activity such as walking, and social activities such as family reunions.
Interdisciplinary Team
Key members of the team may include: – Primary Care Physicians: Oversee general health and promote cooperation among specialists (BĹ‚aszczyk, 2022). Psychiatrists and psychologists are experts in the field of mental health and behavioral problems. They focus on providing specialized treatments for these conditions, which may include cognitive and psychological therapies.
Physical Therapists assist in preserving and improving mobility, balance, and overall physical health. Registered Nurses and Nursing Assistants provide direct patient care, assist with activities of daily living, and monitor and evaluate their health status. An Advanced Practice Registered Nurse (APRN) is responsible for delivering specialized healthcare services via extensive clinical education and training (Emmady & Tadi, 2020). They conduct comprehensive examinations that may include evaluations for concurrent disorders or complications.
CCCR Model
Care teams can use the Comprehensive, Continuous, Coordinated Care method in the treatment of individuals with conditions such as dementia. The CCCR model seeks to provide holistic, patient-centered therapy that accounts for the complex dynamics of the healthcare system (Kuiper et al., 2016). The CCCR paradigm lays considerable emphasis on:
- Holistic care refers to the comprehensive approach of addressing all areas of a patient’s well-being, including their medical, psychological, and functional needs.
- Continuous care: Providing constant and uninterrupted care from the moment of diagnosis to the end of life, if applicable.
- Coordinated care: Ensuring that care delivered by many healthcare experts is well organized and free from any interruptions or deficiencies.
Cost of Care
Between 2022 and 2023, memory care expenses in Riverside, CA, rose substantially. The expenditures increased by about 10.5%, rising from $5,250 to $5,796 (Memory Care, n.d.). The growth rate approximately aligns with the average increase in the United States, which is also about 10.5% (Memory Care, n.d.). Projections indicate that property prices in Riverside are expected to surge by an additional 8% by the end of 2024.
Furthermore, a subsequent 10% escalation in property prices is anticipated across California. Similar to Riverside, the cities of Sacramento, Chino Hills, and Upland in California also saw a substantial increase in inflation, namely by 10.5% (Memory Care, n.d.). The median costs in these locations rose to $6,014, $5,795, and $7,142, respectively (Memory Care, n.d.). The escalating expenses underscore the need for thorough financial strategizing for the care of older people.
Resources
Both national and local sites provide valuable information about financing care and assistance for individuals with dementia. Certain services, such as support groups, may be provided at no cost, while others, such as long-term care, may need payment (Wilbur, 2023). Government initiatives can provide financial assistance for some expenses associated with the care of individuals with dementia (Blair, 2018). For instance, the Program of All-Inclusive Care for the Elderly (PACE) offered by the Centers for Medicare & Medicaid Services may cover the long-term care needs of an individual with dementia living in the community.
According to the Alzheimer’s Association (2023), Medicare Part D may cover prescription medications. However, it often does not cover long-term custodial care. The Benefits Checkup, a free tool provided by the National Council on Aging, may help identify federal and state benefit programs that could help reduce costs and provide access to healthcare and other services. Benefits.gov is another tool that lets you explore and find information on government benefits.
Barriers
Dementia often entails an unfavorable view that may lead to social seclusion and a reluctance to seek a diagnosis or medical assistance. To tackle this problem, it is necessary to raise public awareness to improve understanding of dementia as a medical condition and to promote a more sympathetic, empathetic societal perspective (Memory Care, n.d.). Some individuals may have difficulties accessing specialist healthcare due to geographical, social, or transportation barriers.
Telemedicine and mobile health units are effective means of improving accessibility in underprivileged areas. Coordinating a multidisciplinary team may be complex and demanding. Implementing a case management system or hiring care managers can improve care coordination and streamline communication among healthcare providers.
References
Alzheimer’s disease facts and figures. (n.d.). Alzheimer’s Disease and Dementia.
Alzheimer’s Association. (2023). Dementia vs. Alzheimer’s disease: What is the difference? Alzheimer’s Disease and Dementia.
Arvanitakis, Z., Shah, R. C., & Bennett, D. A. (2019). Diagnosis and management of dementia: Review. Jama, 322(16), 1589–1599.
Blair, K. A. (2018). Advanced Practice Nursing Roles: Core concepts for professional development (6th ed.). Springer Publishing Company.
BĹ‚aszczyk, J. W. (2022). Pathogenesis of dementia. International Journal of Molecular Sciences, 24(1), 543.
Emmady, P. D., & Tadi, P. (2020). Dementia. StatPearlsPublishing.
Kuiper, R., & Pesut, D. J. (2016). Clinical reasoning and care coordination in advanced practice nursing. Springer Publishing Company, LLC.
Memory Care. (n.d.). The best memory care facilities in Riverside, CA. MemoryCare.com.
Wilbur, J. (2023). Dementia: Dementia types. FP Essentials, 534, 7–11.
