A 2012 report published by the United States Senate’s Special Committee on Aging is casting doubt on the nation’s preparedness to treat Alzheimer’s and other dementia disorders.
According to the report, other industrialized nations—including Australia, France and Japan— are all far ahead of the United States in the provision of memory support and other senior care.
Americans pay less for senior care.
The United States pays less as a nation on eldercare not because we need less of it or because it is cheaper here, but because our system relies more upon unpaid help.
According to the Committee’s findings, Americans spend more time providing care to family members or friends in the home than adults in other developed countries.
Of all family caregivers in the US, over 34% are providing 10-19 weekly hours of care– more than double the percentage of family caregivers providing the same amount of weekly attention in most other comparable nations.
It has been suggested that this is a symptom of the America’s tendency to provide less funding for senior care than do other countries.
In Australia, for example, 13.9% of long-term eldercar is given by paid providers, whereas only 6.5% of care in the US is given by paid providers. The responsibility thus falls to unpaid, family caregivers to ensure that seniors’ needs are met.
Why does it matter if care is paid or unpaid?
Well, first and foremost because unpaid caregivers are not held to any regulated standard for eldercare. Unfortunately, there are few mechanisms in place to ensure that seniors are receiving medically-appropriate, safe care, except in extreme cases of criminal neglect.
Many local and state social services for the aging are understaffed and under-resourced.
Seniors relying on volunteer home care can fall through the cracks until they find themselves in an acute care setting. Alzheimer's patients, for instance, are at high risk of fall-related injuries, and instead of receiving paid, preventative memory support, many of these seniors will spiral downward at home until an injury occurs and they require life-saving hospitalization.
To echo the old saying, a dollar spent on prevention might be worth ten dollars of cure.
By providing more government funding to subsidize preventative memory support, we could alleviate much of the burden we place on families to make up for the shortfalls of the system, and improve safety for dementia patients.
From a macro perspective, the United States might in the long-term actually save some of the money we would otherwise waste on repeated cycles of acute hospitalization.
A small to moderate increase in the amount of federal spending on subsidized home care, improving affordable access to primary care and preventative outpatient therapies— just as envisioned in the Affordable Care Act — could prevent unnecessary, expensive surgical and medical ICU stays, as well as the long-term acute care hospitalizations that follow them.
We're not talking enough about the problem.
As the Senate Special Committee on Aging noted in its report last year, the US has only recently instituted its first national plan for improving treatments and care of Alzheimer's and dementia patients; other industrialized nations have been more proactive.
However, the United States is facing a problem that some other nations do not face: our "Baby Boomer" generation was larger than others and that surge in population is already hitting retirement. Within ten to twenty years, the increase in the frequency of age-related dementia disorders in our population could overwhelm an already rickety senior healthcare system.
What can you do?
Get active about this issue. Contact your representatives and senators and demand more action be taken to provide support for those aging at home, and to improve care in nursing facilities.
You can also plan ahead—research the providers in your area and devise a plan for your care. Make sure your wishes are clearly expressed and documented.
If you wish to alleviate some of the responsibility otherwise shouldered by your loved ones, interview in-home care providers in advance and research the services they provide.
See if in-home care will be a feasible alternative for you. If not, scout out retirement communities offering memory support in your area. Find somewhere you can be comfortable receiving the care you will need, that meets your budget needs, and let your family members know how they can best help you.