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The Resource Room
Long Term Care ...... What you Need to Know
Normal Aging/ Dementia or Alzheimer's Disease We all have trouble remembering things from time to time, thinking becomes slower, paying attention is more difficult and memorization is harder. These problems are often noticed with normal aging. Memory difficulties become more noticeable because are body systems become less efficient as we age. The memory loss associated with Alzheimer's Disease progresses more quickly and is much more noticeable to friends and family. " Forgetfulness" associated with normal aging progresses slowly, over time, and usually does not interfere with one's ability to function independently, even professionally. A helpful tool to remember is, when the older adult is experiencing "age-related" memory loss, the person may forget parts of an event and eventually, be able to recall. With Alzheimer's Disease, one may not recall entire events and will unlikely be able to retrieve this information.
The Affect of Illness on Memory Loss It is important to know that memory loss may also be a symptom of something more serious. Memory loss that gets progressively worse and ultimately interferes with everyday life is often the first symptom of Alzheimer's disease. Certain illnesses that affect the mind, such as Parkinson's Disease, Huntington's Disease, conditions of the brain that are caused by strokes, and long- term alcohol use can lead to memory loss. " Forgetfulness" can also occur in people who are suffering from depression. Alzheimer's Disease affects several areas of the brain such as those that are responsible for reasoning, and judgment, in addition to the region that handles memory. For this reason, Alzheimer's affects not only memory, but also certain basic capabilities, such as the ability to find the right words for simple objects or to locate once familiar places. This is the reason why the person with Alzheimer's Disease is rarely able to recall events and are likely to forget entire experiences, not just lapses relating to parts of the event. What is Dementia? Dementia is a term used to refer to a group of symptoms that are the result of deterioration of intellectual functioning such as thinking, remembering, and judgment, and that if severe enough, hinder everyday activities and social relationships. Alzheimer's Disease is the most common cause of dementia in this country and unlike some other types of Dementia, Alzheimer's Disease is irreversible. This means that people with this illness eventually lose the mental capacity to behave in a normal way. Current Statistics
" A recent survey conducted by the NFCA reports that more than one-quarter of the adult population have provided care to a family member or friend during the past year. This number( 54 million) is nearly double what was originally thought." "Recent Information provided by the Alzheimer's Association claims that more than 75% of those with Alzheimer's Disease live at home. The average lifetime cost of the disease per patient is $200,000. Alzheimer's Disease costs American business $33 billion annually, $7billion toward the cost of care, plus $26 billion in lost productivity of caregivers. The annual cost of Alzheimer's care in the United States is at least $100 billion. Health insurance and Medicare do not pay for the long-term care that most patients will require and long-term care insurance must be purchased before the onset of the illness. 10% of people over age 65 have Alzheimer's Disease and nearly 50% of those over age 85 have Alzheimer's. A small percentage of people in their 30's and 40's have the disease Stages of Alzheimer's Disease Life expectancy varies widely. During the disease process, the person may go through a variety of stages. The three most noted stages are mild, moderate, and severe. General patterns are mentioned and do not reflect the experiences of every Alzheimer's patient. Stage 1 - Mild Alzheimer's Disease The first stage of Alzheimer's Disease lasts from 2 to 4 years, symptoms include:
*Memory Loss is usually noted first, followed by forgetting things or asking the same question over and over. Personality changes may become noticed. The patient may become more passive and begin to demonstrate anhedonia (lack of interest in previously enjoyed activities). Stage 2 - Moderate Alzheimer's Disease The moderate stage of Alzheimer's Disease is often the one that lasts the longest, anywhere from 2 to 10 years. For this reason, caregivers become familiar with the way the person is behaving.
Stage 2 is characterized by a further decline in mental functioning. The patient may experience an increase in disruptive behaviors. Unpredictable behaviors may include pacing, argumentativeness, confusion, delusions and hallucinations. Stage 3 Those in the final stages of Alzheimer's Disease, which lasts from 1 to 3 years, require constant care-7 days a week, and 24 hours a day. Those in this stage may not be able to:
Stage 3 patients are dependent on the caregiver and often require in-homecare, or are institutionalized. The patient may be susceptible to malnutrition, infections, pneumonia, and other life-threatening diseases. There may be days when the patient is more lucid and alert, having good days and bad days. This is normal with the disease process.
Treatment Some scientists believe that one reason Alzheimer's disease patients experience memory loss is that they have a dramatic lower level of acetycholine- a brain messenger - that is a neurotransmitter. Scientists also have discovered that an enzyme called acetylcholineterase (eh-set-I-kol-eh-nes-ter-aze) is at least partly responsible for the breakdown of acetylcholine. We now have medications-called "cholinesterase inhibitors" which reduce the breakdown of acetylcholine. Increased levels of acetycholine are believed to improve or maintain certain mental functions such as memory, language, and attention in patients with mild to moderate Alzheimer's Disease. Given that Alzheimer's disease is a progressive disease, even maintaining these functions should be considered a treatment benefit. i.e. Aricept, is one of the more well-known medications used for early onset symptoms of memory loss. - Cheryl Wing
RN,BHN Long Term Care ...... What you Need to Know Back in 1993 the Medicare program changed the way that they pay hospitals. Instead of the traditional reimbursement for services rendered by hospitals, the prospective payment (PPS) system was developed. Today hospitals are paid a flat sum by the diagnosis according to a fee schedule of 467 diagnostic related groups (DRGs) . If the patient leaves the hospital before all the money is spent, the hospital makes a profit. If the patient stays longer than the money lasts, the hospital loses money . Consequently, people are discharged quicker and sicker. Most people must finish their recovery in some location, either by arranging for medical and custodial care at home or in a nursing facility. Medicare will cover for up to 100 days per spell of illness and to qualify one must have a 3 day prior hospitalization for coverage and need skilled nursing care 24 hours per day. Coverage may vary based upon the diagnosis for example, Rehab may be covered for 4 to 6 weeks with recertifications necessary for further coverage. A psychiatric diagnosis may be cover ed for up to two weeks for evaluation of behavior., depending on the diagnosis. After your medicare no longer pays , you are now responsible . If you pay and deplete all of your assets, you may qualify for Medicaid ( Medi-Cal) in Calif. (The government healthcare coverage ) . To receive government health coverage, an individual is only allowed 2,000 in assets and 300 to 500 a month income in 2001. The cost of care in a nursing home nationally, in 1999 was 50,000 , In metropolitan areas this could be more The average stay in a nursing home is just under three years., averaging around 125.00 a day . The average cost of a home visit is 100.00. To bring in an aid 3 times a week to assist with bathing, dressing, meal preparation and other household chores is easily 1,000 a month . Most people who need long term care insurance are over age 65 with about 50% needing long term care however , 40% are younger adult victims of stroke , heart attacks or other serious illness. New Types of Long Term Care There are long term care coverages designed to supplement care given by family members who must answer to many responsibilities., including , Adult Day Care, Home Health Care, Assisted Living Care, Life-Care Facilities, Personal Care, Homemaker Services, and Board and Care . What to look for in a Long Term Care Insurance Policy
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