Literature Review

Alzheimer’s prognosis models should expand data sources McKnights Senior Living; by Kristen Fischer; 8/12/24 Integrating data from nursing home electronic health records and claims in addition to the minimum data set — data required for nursing home residents — could be better than just relying on the MDS sources to produce an accurate prognosis for nursing home residents with Alzheimer’s disease and related dementias, according to a report published Thursday in the Journal of the American Geriatrics Society. ... The authors of the report noted that a recent review of prognostic models for late-stage ADRD found that assessments commonly used to evaluate prognosis-based eligibility for hospice weren’t reliable. ... Only 15% of people enrolled in hospice have a primary diagnosis of ADRD. That’s because it’s challenging to estimate the six-month prognosis required to be eligible for hospice, and dementias have a prognosis of 12 to 18 months when they are in the late stage, the authors pointed out.

Social isolation changes and long-term outcomes among older adultsJAMA Network Open; by Chen Lyu, Katherine Siu, Ian Xu, Iman Osman, Judy Zhong; 7/24Is social isolation change associated with long-term outcomes in older adults? In this cohort study using a national longitudinal health survey of 13 649 adults aged 50 years or older in the US, data revealed that increased isolation was associated with an increased risk of mortality, disability, and dementia. Decreased isolation was associated with a lower risk of mortality only among individuals who were non-isolated at baseline. These results underscore the importance of interventions targeting the prevention of increased isolation among older adults to mitigate its adverse effects on mortality, as well as physical and cognitive function decline.

Nonprofit pledges $4M to expand respite programs for caregiversMcKnight's Home Care; by Adam Healy; 7/26/24The Alzheimer’s Association has pledged more than $4 million in grants that will help community-based organizations enhance respite care programs for caregivers serving people with dementia. “There is an urgent need across the country for dementia-specific respite care programs for people living with dementia and their caregivers,” said Sam Fazio, PhD, the senior director of psychological research and quality care at the nonprofit Alzheimer’s Association, in a statement. “These initial grants will help expand dementia-specific respite care programs and create new ones to support dementia caregivers while ensuring the person living with dementia gets high-quality dementia care in a safe environment.” The grants are part of a five-year program that will direct a total of $25 million to community-based respite service providers.

Resources for people coping with Alzheimer’s disease Everyday Health; by Pamela Kaufman; updated 7/29/24 No one should have to deal with Alzheimer’s alone. The government agencies, nonprofit groups, and other resources listed here can help people with Alzheimer’s and their caregivers cope with the disease through education, advocacy, support services, clinical trial opportunities, and blogs that share the wisdom of lived experience. [This essential list of resources includes:]

A blood test accurately diagnosed Alzheimer’s 90% of the time, study finds The New York Times; by Pam Belluck; 7/28/24 The New York Times says researchers “reported that a blood test was significantly more accurate than doctors’ interpretation of cognitive tests and CT scans in signaling” Alzheimer’s disease. The study “found that about 90% of the time the blood test correctly identified whether patients with memory problems had Alzheimer’s,” while “dementia specialists using standard methods that did not include expensive PET scans or invasive spinal taps were accurate 73% of the time” and “primary care doctors using those methods got it right only 61% of the time.” The findings were published in JAMA and presented at the Alzheimer’s Association International Conference.

Screening for Dementia: A Podcast with Anna Chodos, Joseph Gaugler and Soo BorsonGeriPal Podcast; Eric Widera, Alex Smith, Anna Chodos, Joseph Gaugler, Soo Borson; 7/19/24The US Preventive Services Task Force (USPSTF) concluded back in 2000 that there is insufficient evidence to recommend for or against routine screening for dementia in older adults. Are there, though, populations that it may be helpful in, or should that change with the advent of the new amyloid antibodies?  Should it?  If so, how do we screen and who do we screen? On this week’s podcast we talk with three experts in the field about screening for dementia. 

Does Medicare pay for dementia care? Here’s what coverage you can expect for treatments and therapies Aol - Fortune; by Margie Zable Fisher; 7/18/24 Age-related memory loss is common, but more serious memory problems may be a sign of dementia, which is not a normal part of aging. ... Dementia patients have a variety of medical issues. “In addition to symptoms related to dementia, the overwhelming majority of dementia patients have one or more chronic health conditions,” says Matthew Baumgart, Vice President of Health Policy, at the Alzheimer's Association. Medicare (and Medicare Advantage) provide some coverage for dementia, beginning with the diagnosis, says Baumgart. [Click on the title's link for practical, user-friendly information about what Medicare provides arose the trajectory of dementia's progression. CMS's new GUIDE pilot program is described.]

Senior living providers embrace role in CMS dementia care pilot program McKnights Senior Living; by Kimberly Bonvissuto; 7/11/24 Senior living providers named participants in the federal government’s new dementia care pilot program said they are excited to be part of a new effort to support people living with dementia and their family caregivers. The Center for Medicare and Medicaid Innovation, CMMI, announced the Guiding an Improved Dementia Experience, or GUIDE, model last summer. The Centers for Medicare & Medicaid Services launched the eight-year GUIDE model on July 1 and published the program participant list on Monday [7/8]. Eligible model participants are Medicare Part B-enrolled providers eligible to bill for Medicare services and that provide, or will provide, ongoing care to people living with dementia. Eligible organizations include accountable care organizations, home health and hospice agencies, Programs of All-Inclusive Care for the Elderly, and physician practices. Additional long-term care providers and other healthcare providers, however, can participate as partner organizations by contract with another Medicare provider/supplier to meet the program care delivery requirements. Assisted living residents who are Medicare beneficiaries may be part of the model. Editor's Note: Adding to our previously published posts about the new CMS GUIDE Program (7/10/24 and 7/11/24) and its use by hospice organizations, this article describes its use by senior living care providers. 

CMS: GUIDE Model Participants and Infographic CMS.gov and various press releases; retrieved from the internet 7/10/24 The Guiding an Improved Dementia Experience (GUIDE) Model is a voluntary nationwide model test that aims to support people with dementia and their unpaid caregivers. The model began on July 1, 2024, and will run for eight years. Editor's Note: Multiple press releases are populating across the internet. We share this list of links to information, participants, and sample press releases from well-known participants. 

Four July 4th tips for families caring for loved ones with dementia Alzheimer's Association; 6/27/24 Fireworks and gatherings are staples of the 4th of July holiday, but these can create unique challenges for someone living with dementia. ... “Celebrating Independence Day can still be a fun, enjoyable experience for families impacted by dementia-related illnesses by making the proper adaptations such as being cautious about watching fireworks due to loud noises. It requires thoughtful planning to ensure their safety, comfort, and enjoyment.” said Jennifer Reeder, LCSW, SIFI, AFA’s Director of Educational and Social Services. “Being proactive, prepared, and adaptable, and creating a safe space, are the best ways caregivers can create a dementia-friendly 4th of July for their loved ones.” AFA encourages family caregivers to follow these four tips for the 4th of July:

Harn Art Museum encourages woman with Alzheimer’s to move again ABC TV WCJB-20; Gainesville, FL; by Kayla Lewis; 6/28/24 Pat Mclaurin’s Alzheimer’s has progressed since her daughter, Diana Dodds took her on a bucket list trip in 2022. ... “So my mom would never use a walker or a cane. She would be more likely to try to hit me with it then use it, so she’s fiercely independent, yet she knows right now she cannot really walk without falling,” Dodds shared. “She’s always grabbing for walls just in the house.” ... Pat used to walk 3-5 miles a day, but in January slowed down. They decided to test out their own walker on a trip to the Harn Museum of Art in Gainesville, but her mom didn’t like it. However, the museum offers walkers and Pat loved them. Diana tells her it’s like a shopping cart. “Four wheels, it has higher bars, it had brakes on it. It felt more like a shopping cart because of the seat,” Dodds shared. Diana described the walker they gave her mother to Haven Hospice officials who then brought her mom a walker just like it a couple days later. “It’s inspiring because I’ve seen her push through every step trying to keep moving, and I want her to be able to keep moving,” said Dodds. 

Unity launches Guide that enhances quality of life for dementia patients and their caregivers The Chamber - Manitowoc County, De Pere, Wisconsin; Press Release; 6/20/24 In honor of The Longest Day Of The Year which is celebrated on June 20th to raise awareness and outshine the darkness of Alzheimer's disease, Unity, in partnership with National Partnership for Healthcare and Hospice Innovation (NPHI), announces the release of a new dementia care resources guide that will improve quality of life for dementia and Alzheimer’s patients, reduce hospitalizations, and ease the burden for families and caregivers. ... The new guide represents the best standards of care for mid-, advanced-, to end-stage dementia and was put together with the collective input of 100+ not-for-profit hospice, palliative care, and advanced illness care organizations. [Click on the title's link for more information, and to download the free guide.]

Exploring Experiences of Pain Management Among Family Caregivers of Community-Dwelling Older Adults With DementiaAmerican Journal of Hospice and Palliative Care; by Hui Zhao, Pamela A Kulbok, Ishan C Williams, Carol Manning, Jeongok G Logan, Rafael D Romo; 8/24Pain is often underreported and under-treated in older adults with dementia. The role of family caregivers (FCGs) in managing pain for their loved ones with dementia living in community has been significantly burdensome. ... Family caregivers follow their values to make decisions in pain management. Barriers existed for effective pain management. Adaptation and support from professional or formal caregivers greatly improved FCGs' perception of their competence in pain management. The finding underscores the need for further research and the development of interventions aimed at enhancing FCGs' perception of self-efficacy in this crucial aspect of caregiving.