Dementia and the twin tsunamis!

It is estimated that seven million Americans 65 and older currently have some form of dementia. This population is expected to grow to nine million by 2030, and to 15 million by 2050. This trend is not being driven by the “spread” of a disease; it is being driven by changes in our population. Americans are aging, thanks to an event in our history known as the “Baby Boom.”

After World War II, there was a big increase in the birth rate, and this trend continued for more than 20 years. We call this the “Baby Boom,” which demographers have defined as the period from 1945 and 1965. If you were born during this period, you are a “Baby Boomer.”

If we create a graph that depicts the Baby Boom, then move it 65 years forward, we end up with a graph that generally predicts the growth of dementia today. It predicts that the number of people with dementia will more than double by mid-century. Some dementia practitioners have described this as a “Dementia Tsunami;” an unstoppable wave that can overwhelm our health care system and other community services.

Well, friends, the Dementia Tsunami has begun, and we are totally unprepared. Most health care workers have little or no training for dementia. Even our doctors know very little about dementia, and the standards of training for nurses and nursing assistants in most states have not been updated in 20 years old.

Concepts like Validation Therapy, advanced by Naomi Feil more than 40 years ago, and Hand-under-Hand care methodology that has been taught by Teepa Snow for more than 20 years have not yet been adopted in standard healthcare training. We are being overwhelmed by dementia, but most of our medical community do not understand it or know current best practices in how to manage it.
This is concerning, but it is only half our problem. While our national healthcare needs are increasing, those available to serve are declining. Some researchers estimate that the supply of nurses on the job is 30 percent below demand. The same is true for doctors, nursing assistants, and technical medical personnel; demand is outstripping supply.

So, in respect to dementia, we are facing “twin tsunamis;” an overwhelming growth in demand that is being met by a declining supply of professional care providers.
How do we respond to such a crisis? I’m going to suggest a possibly controversial response: a major national commitment to provide home-based care. To a large extend, this is what we have already. Eighty percent of American families either cannot afford professional care, or choose not to place their loved ones in memory care and assisted living facilities.

Of course, there will always be a demand for professional dementia care for the 20 percent who can afford it, but where is the logic or economic good sense in investing in commercial assisted living for which there is no demonstrable demand?

Instead, I believe we should invest in education and training for families, and by providing better home care, we can avoid the infrastructure costs of the ever-larger assisted living facilities we see being built today. Through my own ABC of Dementia workshops, we have taught the techniques of Person-Centered Compassionate Care to more than 8,000 family care partners, and Florida Elder Options already provides similar training through its Savvy Caregiver Program. Greater investment in home-based care is already being developed as health care policy in some European nations.

We can push back against dementia’s twin tsunamis with old ideas and inadequate resources, or we can invest rather in our families who are – and will be – living with dementia.
I prefer the latter alternative because we all deserve the best.

Until next time remember: “We all deserve the Best”
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