Five million Americans over 65 years are living with Alzheimer’s. This number could nearly triple by 2050, according to the Alzheimer’s Association’s 2020 Alzheimer’s Disease Facts and Figures.  To shed light on the growing need for dementia care and treatment, advocates across the country wear purple the month of June in recognition of Alzheimer’s and Brain Awareness Month.   

Primary care physicians surveyed by the Alzheimer’s Association also recognize the growing numbers and care capacity challenges. In fact, survey respondents expect an increase in Alzheimer’s diagnosis within the next five years; and half doubt the ability to meet the potential demands for care. The full survey results were used to develop “On the Front Lines: Primary Care Physicians and Alzheimer’s Care in America,” a special report within the 2020 Facts and Figures. 

“Individuals experiencing symptoms of dementia have special care needs.We need more professionals who understand and use alternative methods beyond medication to manage personality and behavior changes,” explained Lori Hintz, RN, Certified Alzheimer’s Disease and Dementia Care Trainer (CADDCT) and quality improvement advisor for the Great Plains Quality Innovation Network (QIN). 

Health professionals who are certified geriatricians specialize in treating conditions that primarily affect older adults, which include Alzheimer’s and dementia. According to the American Society of Geriatrics, as of 2018 there were 6,952 certified geriatricians in the United States: 19 in North Dakota and 14 in South Dakota.   

As our bodies age and change, our healthcare needs change with it.  Geriatricians use a very person-centered approach that focuses on preserving independence and quality of life,” explained Stephan Schroeder, MD, CMD, CMQ, medical director at the South Dakota Foundation for Medical Care.  “Personal values and preferences are factored in during the decision-making process for treatment.” 

As the population ages the number of geriatricians in the workforce is not keeping pace.  The Health Resources and Services Administration developed the Geriatrics Workforce Enhancement Program (GWEP) to improve health outcomes for older adults by developing a healthcare workforce that maximizes patient and family engagement by integrating geriatrics and primary care.  The Alzheimer’s Disease and Related Dementias curriculum is used to train the primary care workforce  about dementia and to promote interprofessional teamwork.   

“Individuals living with Alzheimer’s and dementia have complex health needs.  We must work as a healthcare team to provide high quality care,” added Hintz. “Provider shortages and limited access in rural areas bring added challenges for everyone.”    

The University of North Dakota, a 2019 GWEP awardee,  is currently hosting a Geriatrics and Age-Friendly TeleECHO series to improve access to care for patients with complex conditions in rural and underserved communities. The eight-part series began in April and features topics around the 4Ms of the Age-Friendly Health System: What Matters, Mentation, Medication, Mobility.  Starting in June, the Great Plains QIN will host a ‘Huddle’ after each teleECHO session to highlight tools, encourage deeper discussion, and offer best practice sharing.  The topic for June is minimum cognitive impairment.  

The Great Plains QIN values collaboration and is bringing together community and healthcare stakeholders to address challenges and seek solutions while also preventing duplication of effort. Our work focuses on five goal areas, identified by the Centers for Medicare & Medicaid Service (CMS); many of which directly impact individuals living with Alzheimer’s:

  1. Improve Behavioral Health Outcomes, with a focus on decreased opioid misuse 
  2. Increase Patient Safety 
  3. Increase Chronic Disease Self-Management 
  4. Increase Quality of Care Transitions 
  5. Improve Nursing Home Quality  

 Those interested in joining the Great Plains Quality Care Coalition can learn more on our Web site.