Guess how many Americans are currently working as unpaid caregivers for someone with Alzheimer’s disease or another form of dementia?
The answer, says the Alzheimer’s Association, is 11 million. There are currently 6.5 million people suffering from – and dying from – dementia.
To put this in context, there are more unpaid dementia caregivers in the US than paid medical professionals, a total of 9.5 million, including doctors, nurses and medical technicians.
The number of unpaid dementia caregivers is greater than the total number of teachers in America (9.4 million). That is more than ten times the number of lawyers (830,000) and almost twenty times the number of hairdressers and barbers (620,000).
Dementia is the pandemic that rarely gets the headlines it deserves. The numbers are enormous and rising. The costs – emotional and financial – are crippling, once again posing a growing challenge to the US health care system and to Medicare and Medicaid, both of which are facing an emerging crisis.
So a recent pilot program from two American universities – the University of California, San Francisco and the University of Nebraska – is news, or should be.
By providing telephone and online team support, the program was able to achieve significantly better healthcare outcomes for both patients and their caregivers. And, perhaps just as importantly, it has reduced costs to the medical system.
We’re also talking about a lot of money. Over one year, the average Medicare cost for those in the program was $6,300 less than for those not in the program. This was due, for example, to fewer trips to hospital emergency rooms for patients and lower costs associated with treating caregivers for depression. The program itself cost less than $1,300 per beneficiary.
Multiply these numbers by millions and, as they like to say in Washington, you’re soon talking about real money.
The program also produced higher quality of life scores for people with dementia.
The program, called the Care Ecosystem, focused primarily on providing “telephone collaborative dementia care” to caregivers. This involved both proactive and responsive assistance from professional care coordinators, nurses, social workers and pharmacists. The approximately 500 pairs of dementia patients and informal caregivers who received the support were compared with a control group.
The results were published in the Journal of the American Medical Association.
As the researchers indicate, the results are comparable to, but even better than, those of similar projects.
The Biden administration is currently preparing a pilot program called Guiding an Enhanced Dementia Experience, or GUIDE, that will work along similar lines. It is planned to be commissioned in July next year and will last eight years.
It’s not news that the US is facing an “entitlement crisis,” meaning there are big holes in Social Security and Medicare bills. In the case of Social Security, there is no silver bullet: the program consists of money coming in and checks going out to beneficiaries, and there is no way to close the gap except by raising taxes or cutting benefits. But Medicare is different. The program currently spends $1 trillion, and that amount is expected to increase by 50% more than gross domestic product over the next fifteen years. But that money goes toward medical treatments, so if the health care system can deliver the same or better results for less money, that’s outright savings.
This pilot program has produced remarkable gains just by scratching the surface. Although you should never make predictions, especially about the future, you can take this to the bank. There’s going to be a bull market in medical efficiency, and it’s going to keep rolling.