Wide-Ranging Actions Needed to Respond to Growing Alzheimer’s, Dementia Population in CT, Task Force Reports

In a 50-page report to the Connecticut legislature, the Alzheimer’s Disease and Dementia Task Force has outlined a series of 14 wide-ranging recommendations aimed at responding to the needs of a growing number of individuals and families facing the challenges of Alzheimer’s and dementia in Connecticut.

The recommendations include promoting public awareness and best practices including development of an education program for bank personnel, stepped-up dementia-specific training of health care professionals , court personnel and first responders, and improved support of informal caregivers.

The Task Force is urging “mandatory dementia-specific training for hospital emergency room staff, including nurses, physicians and medical technicians,” which may require legislation in the upcoming General Assembly session.  In addition, the Task Force – in another initiative likely to be the subject of legislation- calls for basic level of dementia training for public safety responders, long-term carcovere ombudsmen, protective service employees probate judges and court personnel.

Recognizing that “there are few Alzheimer’s and dementia training requirements for health care professionals and facilities,” the Task Force outlines a series of “detailed recommendations for dementia-specific training requirements across the continuum of care,” including home and community based services such as home health aides, homemakers and companions and personal care assistants.

The report also called for an analysis of the financial impact of developing a Dementia Centers for Excellence (COE) or geriatric assessment units at Connecticut hospitals.

The 25-member task force was formed by the legislature last year, and was administered by Connecticut’s Legislative Commission on Aging.  It was co-chaired by State Rep. Joseph Serra and Department on Aging Commissioner Edith Prague.  The Alzheimer’s Association of Connecticut worked with policymakers on introducing legislation that created the Task Force.  The Task Force met six times over four months, breaking into three subcommittees, which each met 4-6 times, to develop the final recommendations.  The committees focused on 1) Early Detection, Intervention and Planning, 2) Quality Care, Service Delivery and Care Management, and 3) Workforce Training and Development.

According to the Alzheimer’s Association, there are an estimated 70,000 individuals with Alzheimer’s or other dementia.  An estimated 60 to 70 percent of older adults with Alzheimer’s disease and other dementias live in the community, compared with 98 percent of older adults without Alzheimer’s disease and other dementias.  Of those, 75 percent live with someone and 25 percent live alone.  The recommendations also call for:

  • Creation of a public/community awareness campaign through partnerships with agencies and organizations including the Alzheimer’s Association, AARP and Area Agencies for Aging, as well as faith-based and immigrant communities, business/corporate associations, the medical community and resources such as 211.
  • Dissemination of informational packets to be distributed at doctor’s offices, pharmacies, senior centers and other locationsaging
  • Promotion of Medicare Annual Wellness visits which include a cognitive impairment assessment
  • Development of a “bank reporting project” which will train bank employees about “potential red flags” that indicate suspicious activity.  The reported noted that “cognitive impairment poses the most significant risk for exploitation, and bank personnel may be in a unique position to detect financial exploitation of older adult and individuals with dementia.”

To provide greater support for informal caregivers of individuals with dementia, the Task Force is urging development alzof a “train the trainer” dementia course based on the existing Alzheimer’s Association leaders’ training, and drawing on the model of the American Red Cross’ CPR training program to offer “accessible and affordable dementia education to caregivers.”

The Task Force is urging an increase in state funding to expand the Connecticut Statewide Respite Care Program, and to expand and set aside slots for individuals with younger onset Alzheimer’s disease in the Connecticut Home Care Program for the Disabled.

The report also would have the Department of Motor Vehicles “explore policies and regulations related to revoking drivers licenses” and calls on the agency to “take a proactive approach in educating physicians about reporting unsafe drivers to the DMV.” The Task Force also calls for establishment of a care manager registry at the Department of Consumer Protection, a new licensure model at the Department of Public numbersHealth for homemaker and companion agencies and collaborative initiatives with the Department of Social Services.

Julia Evans Starr, Executive Director of Connecticut’s Legislative Commission on Aging, said “It is well-documented that Alzheimer’s and related dementias exact a devastating toll not only on sufferers of the disease, but on the emotional and physical health of their caregivers. Sound public policies that help alleviate emotional and physical stress on affected individuals and their families are imperative, as well as giving these folks choices on receiving care in their communities rather than institutions.”

Dementia is an umbrella term describing a variety of diseases and conditions that develop when nerve cells in the brain die or no longer function normally.  Different types of dementia area associated with distinct symptom patters and brain abnormalities.  Alzheimer’s is the most common type of dementia, which causes problems with memory, thinking and behavior.  Over 5 million Americans of all ages have Alzheimer’s, including one in nine people age 65 and older (11 percent).  That number is expected to increase as the elderly population increases in the coming years.

Task Force Report on State Response to Alzheimer’s Nears Completion

Thirty-one states have published a plan to respond to what advocates describe as the “escalating crisis” of Alzheimer’s Disease. Connecticut may be next, and is one of 13 states currently in the midst of developing plans.

The Connecticut Chapter of the Alzheimer’s Association was among the leaders in crafting and shepherding legislation in the 2013 General Assembly session to create a task force to study the care provided to persons diagnosed with Alzheimer's disease and dementia in the state.  That Task Falzheimers-wordsorce has been up and running throughout the fall, and is poised to announce its recommendations next month, just ahead of the start of the 2014 legislative session in February.

The 23-member task force of key agencies and community stakeholders convened in September, under the auspices of the Legislative Commission on Aging, to prepare findings and recommendations on ways to improve early detection, better coordinate health care services, set training requirements for health care providers and other professionals, services for early-stage and younger onset, and support to family caregialz mapvers.

The Task Force was co-chaired by State Commissioner on Aging Edith Prague and Rep. Joseph Serra of Middletown.  Members included Laurie Julian of the Alzheimer’s Association in Connecticut and other diverse community stakeholders appointed by legislative leadership and representatives from state agencies including the Department of Public Health, Department of Emergency Services, Department of Banking, Department of Labor and Department of Social Services, as well as six current legislators.

Over 5 million Americans are living with Alzheimer’s, and as many as 16 million will have the disease in 2050. Nearly one in every three seniors who dies each year has Alzheimer’s or another dementia. The cost of caring for those with Alzheimer’s and other dementias is estimated to total $203 billion in 2013, increasing to $1.2 trillion (in today’s dollars) by mid-century. Between 2000 and 2010, nationally, the number of people who died as a result of breast cancer, prostate cancer, heart disease, stroke and HIV all declined, while the number of people who died with Alzheimer’s increased by 68 percent.

In Connecticut, there were 820 deaths due to Alzheimer’s Disease in 2010, there are more than 63,000 individuals with Alzheimer’s in nursing homes in the state and it is estimated that 68% of nursing home residents have a cognitive impairment. As of 2010, there were an estimated 2,800 people between age 65-74 with Alzheimer’s in Connecticut, 30,000 between 75 and 84, and 37,000 age 85 or older.

The task force, in accordance with the legislation, will make recommendations in areas including:alz stats

  • services provided to persons diagnosed with Alzheimer's disease and dementia; including persons with early-state and early-onset of Alzheimer's disease, and such persons' family members and caregivers
  • legislative policy changes to better serve such persons, family members and caregivers;
  • coordination between state agencies and private community-based health care providers to serve such persons, family members and caregivers;
  • case management services for such persons, family members and caregivers;
  • the transition of such persons from one health care facility to another; and
  • the placement of such persons in community-based settings or health care facilities other than nursing home facilities, when feasible.

The state legislature acknowledged the growing numbers of residents impacted by the disease, passing the bill unanimously earlier this year, with 67 co-sponsors. It was signed into law in June by Gov. Malloy.  The Alzheimer’s Association has been actively involved in the effort. The organization’s   Connecticut chapter is based in Rocky Hill, with regional offices in Hamden, Norwalk, Norwich and New Milford.

In accordance with the legislation, the task force report is due to be published early next month, according to officials at the State Legislative Commission on Aging.