Over the past 25 years, significant strides have been made in shifting services for people with dementia and Alzheimer’s disease to home and community settings. Home and community-based services (HCBS) enable people with various forms of dementia to receive care in a familiar setting while promoting their independence, well-being, and overall quality of life. As Americans get older, this shift is vital. Shifting care to home and community In recent years, there has been a shift in how dementia care is provided. Twenty-five years ago, nursing homes were commonly chosen for individuals with deme ..read more

The opioid crisis has captured America’s attention, becoming an official “national emergency” and prompting swift action from government agencies, patient advocates, and health care providers. This is as it should be. Over the past decade, opioid overdoses have led to millions of hospitalizations, more than 100,000 deaths, and caused great harm in communities all across America. At the same time, we are ignoring another widespread drug problem: The harm caused by taking too many medications, particularly among older adults. In a recently released report, Medication Overload: America’s Other D ..read more

With a growing recognition of the toll that dementia takes on individuals, families, and communities, there is a movement to prepare our society to better meet the needs of people living with dementia. This movement is referred to as becoming “dementia friendly,” and it can reduce stigma, increase inclusiveness, and improve care. A family example Len Menne (circa 1980). Len recognized me (his granddaughter) as his niece, Dorothy. He told me stories of his sisters – long since passed away – and not knowing why he told me these stories, my 10-year old self encouraged him. We heard the phr ..read more

What are the potential impacts of COVID-19 on health care utilization? How will changes in healthcare use impact quality measures? Researchers are asking many key questions to understand the impacts of COVID-19. It is clear that trends in healthcare use are changing. These changes will likely affect quality measure scores in the future. This is especially true for healthcare value-based purchasing and quality improvement programs that adopt health care utilization “outcomes” measures to assess quality of care.  Assessing changes in health care data and health care use will be critical to ..read more

Inappropriate antipsychotic medication use among older adults with dementia is associated with increased risk [pdf] of hospitalization and death. In 2017, the rate of potentially inappropriate use was 16%, having fallen from 24% in 2011. While this decline has been substantial, further decreasing the rate is an important goal to protect the health and wellbeing of nursing home residents. The new target of the National Partnership to Improve Dementia Care in Nursing Homes is a 15% reduction in the rate by the end of 2019. Over the years, there have been many potential efforts to address this p ..read more

When COVID-19 forced sudden lockdowns in 2020, Americans realized quickly that the supply of services available at home did not match growing quarantine demands. Both the public and private sectors responded with shifts to delivering contact-free services. That pandemic shift may have long-term benefits for older adults seeking services to support aging in place. Pandemic Impact Across Age Groups Starting in 2020, the COVID-19 pandemic and associated quarantines meant that people of all ages suddenly stayed home. The US Bureau of Transportation Statistics reported that most of us traveled less ..read more

COVID-19 has severely affected nursing homes. As of now, over 139,270 residents and 2,155 nursing home staff have died from COVID-19. This post provides insight on the questions researchers are asking to understand the impact of nursing facility factors on COVID-19. A Perfect Storm The combination of a frail, aging population, close living quarters, and in some cases a lack of resources has contributed to a “perfect storm” [PDF] of COVID-19 cases and deaths in US nursing homes. However, researchers are still determining which nursing home characteristics might contribute to COVID-19 cases. Sin ..read more

The Alzheimer’s Association’s 2021 Alzheimer’s Disease Facts and Figures report [PDF] shares that currently, six million Americans are living with Alzheimer’s disease, a number that has increased 145% since the turn of the century.  Around the world, there are 50 million people living with Alzheimer’s disease or related dementia. Only a quarter of would-be patients are diagnosed. Access to Alzheimer’s disease testing is especially critical for racial and ethnic minorities [PDF] who are at higher risk of dementia and face discrimination in seeking dementia health care. Moreover, the Admini ..read more

Long-term services and supports (LTSS) for older adults and persons with disabilities have become a policy priority. The American Rescue Plan and the proposed American Jobs Act aim to increase LTSS spending through the Medicaid program, particularly for Home- and Community-Based Services (HCBS). These measures would address the need for wider service availability, while presenting an opportunity to reduce disparities in access to and receipt of Medicaid HCBS. Medicaid HCBS 101 Medicaid HCBS are a type of LTSS that provide in-home care to low-income older adults, children and adults with disabi ..read more

John bowled in a Friday night league for 20 years. It was often the highlight of his week – a chance to spend time with friends, blow off some steam, and enjoy some friendly competition. Now 75 and living with dementia, John has tried more than once to walk to a bowling alley that no longer exists. Each time, his adult children have located him unharmed. With his continued dementia and wandering, they are growing increasingly concerned about the “next time”. Photo by James Goneaux from FreeImages Like so many people impacted by dementia, John’s family – and his community – are faced with que ..read more