I Will Never Forget

I_Will_Never_Forget_CoverLast week I shared with Pub patrons the amazing night at the 2014 LeadingAge annual meeting featuring the premier of Glen Campbell: I’ll Be Me. As a follow up to that and to contribute further toward the education and awareness of the challenges associated with caring for individuals afflicted with Alzheimer’s disease and other forms of dementia I wanted to share with you Elaine Pereir’a book, I Will Never Forget.

Elaine tells the story of her mother’s battle with dementia and how it turned a brilliant woman into someone confused, compromised and agitated in its wake. It is a tribute to her mother’s journey – and it was written for everyone facing a similar journey.

Elaine is a retired school occupational therapist who has worked with special needs children. She earned her bachelor’s degree in occupational therapy from Wayne State University and later completed her master’s degree. She can be reached at


LTC Mainly About Dementia Care

Today is World Alzheimer’s Action Day. And this past week Alzheimer’s Disease International issued, World Alzheimer Report 2013 ~ Journey of Caring: An Analysis of Long-term care for Dementia. As noted there, “ Long-term care for older people is, mainly, about care for people with dementia. Dementia and cognitive impairment are by far the most important contributors, among chronic diseases, to disability, dependence, and, in high income countries, transition into residential and nursing home care.”

Recognizing how integral dementia care is to developing public policy that address the needs of seniors in need, I thought this was a good opportunity to make available again the webinar my Artower colleague Dr. Lori Stevic-Rust did a little over a year ago.

Organizations that are interested in getting out ahead of the curve on developing care programs for individuals with Alzheimer’s/dementia that bring high value to integrated care delivery models under Healthcare Reform will benefit from watching this presentation.


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   Play Webinar                     Download Slides

The Rising Costs of Dementia Care

Research published today in the New England Journal of MedicineMonetary Costs of Dementia in the United States – describes the projected economic consequences of caring for an aging population afflicted with various forms of dementia, including Alzheimer’s disease.

Separating the caregiving related costs attributable to dementia is challenging, if not impossible, because of the prevalence of comorbidity in individuals having dementia and because of the lack of quantifiable data reflecting the financial burden associated with informal caregiving. Using data from the University of Michigan’s Health and Retirement Study, the study’s authors sought to adjust for such phenomena by parsing out data that is believed to reflect the marginal costs associated with dementia.

Their methodology looked at how these costs could vary over the spectrum of probability within a given population that an individual would be afflicted with dementia. Costs were stratified according to:
     Out of Pocket Spending
     Spending by Medicare
     Net Nursing Home Spending
     Formal and Informal Homecare

If the intuitive concern that the economic impact of an aging society will be dramatic, the aggregate cost projections from this research certainly reinforces that concern. With a prevalence rate of 14.7% of the US over the age of 70 having dementia, the current (2010) cost of care (not including the valuation of informal caregiving) is $109 billion. By 2040, if prevalence rates and utilization of non-informal services and care are held constant, that amount is projected to more than double.

The authors note that dementia is one of the most costliest diseases to society, yet 75% to 84% of attributable costs of dementia are related to institutional care (e.g., a nursing care facility) or home-based long-term care – i.e., as opposed to medical care. Healthcare providers in that space should recognize the challenges and opportunities of that consequence.

I think it is important to remember that the inherent subjectivity of the dataset – and the data elements represented – is a reality that cannot be overlooked. In addition, even if there wasn’t the inherent subjectivity, I’m not really sure of the article’s value, nor whether it is deserving of the attention received in the press. Perhaps there’s something there I missed.

Counting the number of teeth a shark has and noting their regenerative capabilities is a fascinating exercise, but it’s the shark that can kill you – not its teeth.


Special Note: last summer I shared with Pub visitors a webinar, Emerging Trends and Drivers in Dementia Care, presented by my Artower colleague, Lori Stevic-Rust, PhD ABPP, Board Certified Clinical Health Psychologist and nationally recognized authority on Alzheimer’s disease. Another plug here seems appropriate.