NC must prepare for the coming Alzheimer’s crisis


The figures are stunning, but they are true: In less than 10 years, almost 400,000 people in North Carolina will have been diagnosed with Alzheimer’s disease and other forms of dementia.

No wonder that the N.C. Institute of Medicine, charged by the state with studying critical health issues, makes Alzheimer’s a top priority. The Institute and advocates are pushing for legislative action to invest more in help for Alzheimer’s victims and their families, particularly those loved ones who care for people they’re trying to keep in comfort at home. The state currently is shortchanging them, with a cut to a program that helps them and little assistance forecast in the immediate future.

That must change. Now.

It is a familiar refrain, and one with a louder and louder chorus: In addition to the tragedy of Alzheimer’s for those felled by it, there is the overwhelming burden for family members who try to care for those who have this disease and other forms of dementia.

More and more families can share the story: A son or daughter, and that son or daughter’s children, try to care for a mother or father stricken with Alzheimer’s and beginning the descent into an inability to care for oneself. There is the feeling, now shared by so many, that it’s better, if at all possible, to try to care for that loved one at home, somehow, even though it means considerable sacrifice.

The Institute wants a state strategy for dealing with the disease. The legislature’s Joint Oversight Committee on Health and Human Services has heard now a multitude of recommendations. The bottom line is that the state has to get more involved in ensuring care. There is but one state-funded program, Project CARE, focused exclusively on dementia. Its budget was cut in 2011, and with that cut the project’s ability to provide respite care for care-givers – family members trying to cope – was virtually eliminated.

That’s a poor decision on many levels. But purely on a smart-management, money-saving basis, it was foolish. Dr. Adam Zolotor, the president of the Institute of Medicine, notes that every $100 spent on respite services reduces a person’s placement in a nursing home by one week. That week obviously costs many times the investment in respite help.

In addition, there is a Medicaid waiver program that allows more services for families caring for people with Alzheimer’s. That also delays the placement of people in long-term care facilities, all of them expensive. The waiting list for the program runs to 8,000 people and two years.

Rather than cutting the Project CARE budget, legislators ought to increase it many fold. A statewide oversight agency should be established to focus on this issue. Legislators also should pass laws specifically aimed at protecting the health and safety of Alzheimer’s victims and assisting those who care for them.