1. ACT on Alzheimer’s Disease Curricula Module III: Societal Impact

2. Societal Impact • These slides are based on the Societal Impact text from Module III • Please refer to the text for all citations, references and acknowledgments

3. 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. • Raise awareness of the anticipated increase and impact Alzheimer’s disease will have in the future.

4. 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

5. Impact on Families and Caregivers

6. 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 2011, these caregivers provided an estimated 17.4 billion hours of unpaid care at an estimated value of $210 billion

7. 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

8. 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

9. 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

10. Impact on Families and Caregivers • Caregivers are at risk for becoming “secondary patients” • The physical and emotional stress of caregiving is estimated to result in $8.7 billion of additional 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

11. Financial and Healthcare Impact

12. 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

13. 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

14. 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

15. 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

16. 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 $79-87k/year) causes patients to spend down their assets which ultimately leads them to become Medicaid beneficiaries

17. Financial and Healthcare Impact • Total payments for health care, long-term care and hospice for people with Alzheimer’s are projected to be $200 billion in 2012 • Total payments are expected to increase to $1.1 trillion by 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