Memory Loss and Memory Care in the 65+ Community

INTRODUCTION

America’s population is aging at a rapid pace. According to the HHS Administration on Aging, almost 15 percent of the US population is 65 or older. In some communities, the rate of aging is even higher. It is projected that over the next decade the overall number of Americans 65 or older will double. It is also projected that the much older population of 85+ will triple from 6.3 million in 2015 to 14.6 million in 2040.

With these growing numbers and rising rates comes new challenges and responsibilities—ones that caregivers must take on in order to provide the very best of quality of care for the aging. This article aims to lay out the current landscape in the US as it pertains to the aging population; as well as demonstrate ways in which memory care programs assisted by technology can improve the quality of care for elderly residents, patients, and citizens.

AGING OF AMERICA

In addition to these larger numbers and rising rates, there are other changes occurring among America's older population. Today’s older Americans possess higher levels of education, but work for longer periods of time; they suffer from higher rates of obesity, yet face lower rates of poverty than generations past. Recent statistical trends also show that the gap in life expectancies between men and women is narrowing. In 2018, it is projected that the life expectancy of a woman from the United States will be 81 years. These trends regarding aging in America will have significant impacts on the economy, healthcare coverage, the business sector, and providing long-term healthcare.

MEMORY LOSS IN THE OLDER POPULATION

The US Centers for Disease Control indicated that “1 in 9 Americans aged 45 and older are experiencing Subjective Cognitive Decline”. Subjective Cognitive Decline (or Impairment) is the self-perception that one's mental abilities, including memory, are in decline. Researchers have identified that subjective cognitive decline is a precursor to mild cognitive impairment—an early predictor of Alzheimer’s disease development. Individuals who are experiencing cognitive decline or impairment symptoms have difficulty with memory, thought processes, and in some cases, daily functioning.

Alzheimer's disease is the most common cause of dementia among older adults. The 2016 World Alzheimer’s Report stated that there are roughly 47 million people living with memory loss across the globe. In 2017, of the estimated 5.5 million Americans living with Alzheimer's dementia, an estimated 5.3 million are age 65 and older. This means one in 10 people age 65 and older live with Alzheimer's. Interestingly, approximately 200,000 individuals are under age 65 and have younger-onset Alzheimer's.

The Alzheimer’s report also identified several lifestyle factors as useful tools in predicting the risk of developing dementia for those between the ages of 60 and 79. These lifestyle indicators included smoking tobacco, heavy alcohol use, an abnormal body mass index, the use of certain prescription drugs, overall heart health, and social activity.

IMPROVING MEMORY

Memory experts offer several suggestions to improve memory and slow cognitive decline. These recommendations include:

1. Follow your doctors recommendations, especially if you are being treated for a chronic disease that requires medications or routine testing;
2. Organize your living areas to remove clutter and distractions to quicken the time necessary to find items;
3. Socialize regularly to stay connected with friends and families;
4. Get plenty of sleep;
5. Eat a healthy and well balanced diet;
6. Participate in physical activity and regular exercise; and
7. Engage in brain activities such as crosswords, word puzzles, bridge, or other card games

In addition to these recommendations, memory aids can improve memory as well as language skills. A well-designed memory program (such as iN2L's Memory Care Program) can assist in recalling information, actions, and people. Specifically a memory aid can help:

1. Organize thoughts more rapidly
2. Retain multiple ideas or facts simultaneously
3. Select or use the correct word or phrase
4. Perform complex calculations
5. Remember details
6. Evaluate information to improve decision making

EMPLOYING TECHNOLOGY IN MEMORY LOSS CARE

Family, friends, and caregivers face many challenges in helping and supporting an individual with memory loss. Working with professionals, it is important to identify personalized and realistic goals for the individual that include a range of functions and engagements. There are several technological tools that are available that can be utilized to meet these goals and objectives.

In an assisted living or long-term care setting, these tools provide a cost-effective methodology for caregivers that can lead to increased staff productivity,  efficiency, and reduction of one-on-one labor costs. In some cases, these tools may qualify for as minute credits for respite therapy from health insurers and payers.

The Centers for Medicare and Medicaid Services (CMS) has issued regulations known as CMS F-tag for long term care facilities—who often admit and care for individuals with memory loss. For facilities that accept Medicare/Medicaid reimbursement, complying with these regulations with regard to memory care is essential.

Employing technology that is personalized for the resident is an important component of an assisted living facilities' compliance program, and a key differentiator in the marketplace. To assist in meeting these requirements, the Alzheimer’s Association has released Dementia Care Practice Recommendations that outline several components. They include:

1. Person-centered care;
2. Detection and diagnosis;
3. Assessment and care planning;
4. Medical management;
5. Information, education, and support;
6. Ongoing care for behavioral and psychological symptoms of dementia, and support for activities of daily living;
7. Staffing;
8. Supportive and therapeutic environments; and
9. Transitions and coordination of services;

When selecting technology, there are several critical factors to consider in providing the most effective assistance for the individual. Technology needs to include content that is engaging as well as easy to use, especially for older adults who may not be technology-savvy. The content should provide the ability to personalize material to meet individual instruction needs and personal preferences. The technology should also have flexibility built into the programs to keep the games from becoming repetitive, while simultaneously challenging the individual in different ways.

CONCLUSION:

In summary, the American population is aging, especially in the 85+ demographic. The aging of America poses unique challenges in regards to helping this population. Families and caregivers need to provide meaningful and useful memory tools to combat age related diseases such as dementia and Alzheimer’s. Technology will continue to play an important role in the overall treatment plan for memory loss.

References:

1) Memory Function and Supportive Technology.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874241/

2) Alhzeimer's Facts. https://www.alz.org/

3) Subjective Cognitive Decline.                                 https://www.ahrq.gov/sites/default/files/publications/files/lepguide.pdf

4) A Profile of Older Americans; 2016, Administration on Aging HHS. https://www.acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2016-Profile.pdf

5) Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/GuidanceforLawsAndRegulations/Nursing-Homes.html

Photo: Pictures by Ann via Flickr