1 Individuals with Dementia: Long-Term Care Policy Challenges Matthew Baumgart Senior Director, Public Policy Alzheimer’s Association

2 Some Basics Not just a “little memory loss” – and not a normal part of aging Progressive disease that destroys brain cells, causing problems with memory, thinking, and behavior Eventually, takes away ability to communicate, move, and swallow Ultimately, fatal

3 Some Facts ,000 Million 1 in 9 AmericansAged 65 and Over 1 in in 3Half Don’t Know 6th Americans living with Alzheimer’s disease leading cause of death in America

4 Some Arkansas Facts 60,000 Arkansans living with Alzheimer’s disease 122% increase in number of deaths between % percentage of 60+ with worsening memory problems 81% have not talked to a health care provider

5 in costs to American society of caring for individuals with Alzheimer’s disease Billion $203 “skyrocketing at a rate that rarely occurs with a chronic disease” --New York Times of AD life spent in most severe stage The Costs $107B Medicare $35B Medicaid $34B Out of Pocket $27B Other Average Per Senior Medicaid Spending W/O AD/D$549 W/ AD/D$10,538 19X HIGHER WHY? 40% In Nursing Home by 8075% Senior Residents w/ AD65% People with Alzheimer’s more likely to be on Medicaid Without AD/D11% With AD/D29% AD Medicaid Residents51% People with Alzheimer’s more likely to be in nursing homes “the most expensive malady in the U.S.” --Associated Press “exceeding that for heart disease and cancer” --Bloomberg News

6 The Caregivers 15.4 Million 17.5 Billion $216.4 Billion unpaid caregivers value of unpaid care hours of unpaid care 172 Thousand 196 Million $2.4 Billion

7 Living Alone 800 Thousand live alone 25% of those in the community 31.7% with worsening memory problems who live alone

8 If you are talking about long-term care, you are talking about people with dementia. Improving the long-term care system is crucial for people with dementia.

9 Valuing people with dementia and those who care for them Treating people as Individuals Looking at the world from the Perspective of the person with dementia A positive Social environment in which the person living with dementia can experience relative well-being The Policy Challenges Person-centered care More home- and community-based services Less restrictive options Change in Per Capita Senior Health Care Spending, Seniors without AD/D Home Care Nursing Home Care Nursing Home Seniors with AD/D

10 If you have a system that is dementia-capable, you have a system that is capable for all. Closing Thought