Demography is a useful tool for projecting social challenges that must be addressed in the future. Whether through steady increases in the number of births that occur in the U.S. or through immigration, this country’s population will continue to grow. Perhaps more importantly, both numerically and proportionately, increased growth will occur among individuals ages 65 and older. This cohort also will be distinguished by the disproportionate existence of various chronic co-morbidities that will strain the nation’s ability to address health and health-related social needs pertaining to problems, such as dementia. Three major sectors in the health sphere can play important roles in undertaking improvements in the years that lie ahead.
Higher Education Institutions in the health professions must continue to place an emphasis on ensuring that education programs will enable students to work cooperatively and effectively in team-based care with members of other professions. These schools play a fundamental role in the production of adequate numbers of graduates to serve as faculty, researchers, and clinicians. The latter group should be equipped with the ability to furnish high quality care to a broad spectrum of patients with dementia that differ according to key factors, including age, gender, race/ethnicity, culture, health literacy, and digital competency. A necessary set of skills will involve the provision of person-centered care that includes taking into account patient preferences, their life history, and opportunities to advise them about ways of achieving dementia risk reduction.
Clinical Settings will entail service delivery by health care providers working in conjunction with informal caregivers in the home environment. Both as part of their formal educational preparation and in providing patient care, a necessary skill will be an ability to offer education for the informal group to become competent in providing care to in-home patients. These individuals should be able to support medication management within the home setting, especially since improper pharmaceutical use is associated with an increase in fall risks among individuals living with dementia. Caring for this kind of patient is distinctive insofar as they may experience progressive declines in physical, cognitive, and emotional functioning. Because some caregivers themselves are in advanced age brackets, they may be at risk of stress-related declines in physical and mental health status.
Policymakers work in government programs, such as Medicare and Medicaid, and health insurance companies in the private sector. Recognizing the burdens placed on informal caregivers in the home setting, there needs to be increased opportunities for these individuals to benefit from respite services. The WHO in 2019 published its first evidence-based guideline on dementia risk reduction, which currently must be implemented into policy and practice. Direct and indirect costs of dementia will continue to soar unless changes are made in the way care is delivered. A greater understanding is needed of how cognitive impairment affects care delivery costs in the context of the Medicare home health benefit. Health insurance coverage options are complicated and confusing. Additional efforts are required to make this information more understandable for all concerned parties.