PHYSICIAN'S UPDATE MARCH 2009: A partner in the complex medical management of your patients with Alzheimer’s disease

An estimated 5.2 million Americans are living with Alzheimer's disease, and the number will escalate rapidly in the coming years as the Baby Boom generation begins reaching retirement age in 2011, just 2 years from now..1

Caring for this growing number of persons with Alzheimer’s or another dementia will strain our health care system. People with Alzheimer's disease and other dementias are high users of health and long-term care services, with direct costs to Medicare and Medicaid amounting to more than $112 billion annually. 1 This patient population has more than three times as many hospital stays as other older people, and the use and cost of health care services are strongly related to coexisting medical conditions. Most patients with Alzheimer's or another dementia have one or more comorbidities, including hypertension (60%), coronary artery disease (30%), congestive heart failure (28%), and diabetes (21%). 1

Medical care and management for these patients can be complex for physicians, as patients with diminished capacity may be unable to play an active role in their treatment.

For your patients with Alzheimer's disease or another dementia, Alzheimer's Family Services Center, a Hoag Community Health Partner affiliated with the Hoag Neurosciences Center, offers a resource to help you manage your patient's with Alzheimer's and their coexisting conditions.

Day-to-day monitoring of Alzheimer's and comorbidities
Alzheimer’s Family Services Center offers adult day health care services designed specifically for persons with Alzheimer’s disease or another dementia. While at the center, participants enjoy cognitively and physically stimulating activities, and benefit from health-related services. A multidisciplinary team of dementia care experts, including a medical director, nurses, social workers, physical, occupational, and speech therapists, a pharmacist, and a dietician, develop an individual care plan that supports maximal independence. All care is coordinated with primary care physicians. For example, the team helps facilitate care with primary care physicians and specialists through daily management of each participant's health conditions (e.g., blood pressure and blood glucose readings) and medication regimen (e.g, administering daily medications and monitoring side effects), sending reports on patient progress, and alerting doctors to any medical issues that arise. The team also helps physicians and families address the behavioral and psychological symptoms of dementia.

Services extend well beyond medical care coordination
Seventy percent of people with Alzheimer's and other dementias are living at home at any one time, usually with help from family and friends. Caring for a person with Alzheimer's impacts the caregiver's employment and health, contributing to high levels of stress hormones, reduced immune function, new hypertension, new coronary artery disease and depression. 1 Alzheimer’s Family Services Center has developed a continuum of services to help families address the multiple challenges that arise during the course of dementia, from the earliest to most advanced stages. Caregivers of participants enrolled in adult day health care as well as from the community at large can take advantage of the multiple services.

Alzheimer’s Family Services Center ground its services in the latest in research on dementia treatment and care. For example, studies have now repeatedly shown that patients who engage in cognitive stimulation, such as that offered at the Center, and take available medications (e.g., Aricept) show less decline than those receiving pharmacological treatment alone. On a daily basis, all participants exercise the brain through current events discussions, reminiscence, trivia, word games, puzzles, and bingo. Team games give early stage participants a way to exercise the memory, language, and other skills they want to maintain as long as possible. Additionally, participants can access the innovative Brain Fitness™ system, which engages them in stimulating yet rigorous cognitive exercises via a touch-screen computer.

Alzheimer's Family Services Center provides a truly unique service to the community, offering support for referring physicians, the patients themselves, and their caregivers.

For more information, please call Alzheimer's Family Services Center at 714/593-9630 or visit www.AFSCenter.org.

Reference:
1. Alzheimer's Association. 2008 Alzheimer's disease facts and figures. Alzheimer's Dement. 2008;4(2):110-133.