act on alzheimer’s disease curriculum module iii: societal impact

ACT on Alzheimer’sDisease Curriculum

Module III: Societal Impact

Societal Impact

• These slides are based on the Module III: Societal Impact text

• Please refer to the text for all citations, references and acknowledgments

2

Module III: Learning Objectives

Upon completion of this module the student should:

• Identify the challenges that families and caregivers experience when caring for someone who has dementia.

• Gain insight into the cost, risks, and stressors that affect families and caregivers.

• Be aware of the anticipated increase and impact Alzheimer’s disease will have in the future.

Societal Impact of Alzheimer’s Disease

• Alzheimer’s disease has a serious impact on many facets of society– The burden of Alzheimer’s disease has a profound

impact on patients, families and caregivers– The disease jeopardizes the financial well-being of

patients and families as well as puts strain on public budgets

– Alzheimer’s disease has placed, and will continue to place, an increasing burden on the overall healthcare system

Impact on Families and Caregivers

Impact on Families and Caregivers

• 15 million Americans provide unpaid care to a person with Alzheimer’s disease or other dementia

• Unpaid caregivers are primarily family members

• In 2012, these caregivers provided an estimated 17.5 billion hours of unpaid care at an estimated value of $216.4 billion

Impact on Families and Caregivers

• Caring for a person with dementia poses special challenges

• Caregivers experience high levels of stress and negative effects on their own health, employment and financial security

• Caregivers are at a heightened risk for psychological and physical illness

Impact on Families and Caregivers

• Frequent issues experienced by families and caregivers include:– Denial– Anger / Frustration– Guilt– Loss and Grief– Letting Go– Financial Stress– Role Reversals– Social Isolation

Impact on Families and Caregivers

• Caregivers report high levels of stress over the course of providing care– 61% rated the emotional stress of caregiving as

high or very high– 33% report symptoms of depression

Impact on Families and Caregivers

• Caregivers are at risk for becoming “secondary patients”– The physical and emotional impact of dementia

caregiving is estimated to result in $9.1 billion in health care costs in the United States

– 75% of caregivers reported that they were somewhat to very concerned about their own health while serving as a caregiver

Financial and Healthcare Impact

Financial and Healthcare Impact

• As the population grows and ages, there is a growing need for healthcare workers– The United States will need another 3.5 million

health care providers by 2030 to maintain the current ratio of provider coverage

– The number of trained geriatricians is very low and the need is growing in the medical, nursing and social work fields

Financial and Healthcare Impact

• People with Alzheimer’s disease and related dementias have three times as many hospital stays as do others

• Medicare beneficiaries with Alzheimer’s are more likely than those without to have other chronic medical conditions

• As a result, the total health care costs of Alzheimer’s patients is higher than the costs of similar non-Alzheimer’s patients

Financial and Healthcare Impact

• Use of healthcare facilities:– Hospital: 3x stays for Medicare patients with

Alzheimer’s vs. those without Alzheimer’s– Skilled nursing facility: 9x stays for Alzheimer’s

patients– Home health care: 23% with Alzheimer’s had at

least one home health care visit vs. 10% for non-Alzheimer’s beneficiaries

Financial and Healthcare Impact• The costs of health care services are higher for

those with Alzheimer’s disease– Total payments for all health care and long-term care

for Medicare beneficiaries with Alzheimer’s were 3 times higher than for those without Alzheimer’s ($44k vs. $14k)

– 29% of Medicare patients with Alzheimer’s also have Medicaid; 10% of Medicare patients without Alzheimer’s also have Medicaid

– Medicaid payments for beneficiaries with Alzheimer’s were 9 times higher than for non-Alzheimer’s Medicaid beneficiaries

Financial and Healthcare Impact

• The high cost of long-term care is a challenge for Alzheimer’s patients and their families– 60-70% of older adults with Alzheimer’s disease

live in the community vs. 98% of older adults without Alzheimer’s

– The high cost of long-term care services (assisted living $42k/year and nursing home $81-90k/year) causes patients to spend down their assets which ultimately leads them to become Medicaid beneficiaries

Financial and Healthcare Impact

• Total payments for health care, long-term care and hospice for people with Alzheimer’s are projected to increase. • $203 billion in 2013• $1.2 trillion in 2050

• The increase assumes a six-fold increase in government expenditures under Medicare and Medicaid and a five-fold increase in personal out-of-pocket spending