RD439 - Report on Interdisciplinary Memory Assessment Clinics – December 1, 2016

Executive Summary:
The Department for Aging and Rehabilitative Services has been awarded $1.68 million in federal funding to implement three programs (counseling, care coordination, and education). Collectively the three programs form the core specialized services of an interdisciplinary Memory Assessment Clinic, which can diagnose and treat dementia while offering care coordination and specialized services for both the patient and their caregiver. Grant funding has provided the opportunity to pilot and adapt these programs, and ultimately lay the foundation for establishing regional Memory Assessment Clinics.

Current estimates indicate 140,000 individuals aged 65 and older are living with Alzheimer’s disease in Virginia and 455,000 caregivers provide assistance to a loved one with dementia. According to national averages older adults with dementia require 171 hours of care per month in comparison to the 77 needed by older adults with other chronic conditions. Often caregivers feel overwhelmed by the responsibility and desperately need support. Regional Memory Assessment Centers can provide this support and assist persons with dementia to age in their environment of choice. Current federal funding will be exhausted by the end of February 2018.

Over the last two years, 130 caregivers of persons with dementia have been enrolled in the counseling program, which includes meeting with a counselor for six sessions. Of the six sessions, four of them include family members and friends. These sessions are important to establish a support system for the caregiver and find ways to distribute the caregiving responsibilities. Caregivers also discuss issues and challenges they are encountering and receive guidance. The caregivers have experienced fewer symptoms of depression, feel less burdened, visit their physician less often, and feel they have been able to keep their loved one at home longer.

Since the spring of 2016, 47 persons newly diagnosed with dementia enrolled in the care coordination program. A Dementia Care Manager helps the participant to understand their condition and know what to expect. Depending upon the unique needs of the participant or their caregiver the manager may help them apply for Medicaid, arrange for the participant to attend an adult day center, or assist them in joining support groups. Additionally, seven residents with dementia residing in an independent living community have participated in a 10-week educational program. Sessions are devoted to teaching the participants effective strategies for coping with their condition. Topics include memory strategies, financial resources, planning for the future, fall prevention, medication management, exercise, managing health, assistive devices, social engagement, talking to people about dementia, and home safety.

Outcomes for the care coordination and education programs are not available at this time. However, anticipated outcomes include fewer symptoms of depression, a decrease in the use of unplanned or emergency healthcare, an increase in steps taken to prepare for the dementia, and an increased understanding of strategies to cope with changes in memory.

The three programs described in this report have served a collective total of 187 participants and are designed to support persons with dementia to live in the community longer and to decrease the burden felt by their caregivers. If the care recipients of the participating caregivers and the participants with dementia were delayed from residing in a nursing facility for only 2 months, it would save approximately $2.5 million. The Alzheimer’s Disease and Related Disorders Commission recommend the 2017 General Assembly support the development and funding of interdisciplinary Memory Assessment Clinics with Dementia Care Managers.