Date: October 1st, 2012
If you or a loved one has been diagnosed with Alzheimer’s disease, you’ve most likely wondered if there are any ways to relieve some of the burden of the disease, in addition to the pills to manage its symptoms. For many diseases like heart disease and diabetes, changes to diet and exercise are as high on health care providers list of advice for patients as a prescription for medication, but this isn’t the case with how they approach Alzheimer’s disease.
You may be surprised to learn that many non-pharmacological (drug) treatments and care practices--for both people with Alzheimer’s disease and their caregivers--have existed for decades. It’s only surprising because information on these treatments can be difficult to find, you typically don’t hear about them from a doctor or insurance company, and they’re not widely available in communities across the country. But why?
Getting Our Bearings
In May the National Plan to Address Alzheimer’s Disease was released by the U.S. Department of Health and Human Services. In addition to addressing a number of other objectives, this plan calls for a comprehensive review of non-drug treatments and care practices for people with Alzheimer’s and their family caregivers. This past June, the Alliance for Aging Research partnered with the U.S. Administration on Aging and the MetLife Foundation to convene a meeting of top experts to conduct this review. These experts also made recommendations about next steps that could serve as a roadmap for what needs to be done to make these treatments available to more people who need them.
Research conducted in the U.S. shows that more than 40 non-drug treatments and care practices have positive effects for some people with Alzheimer’s who live in the community, and their family caregivers. This meeting looked specifically at 11 of these treatments--ranging from structured groups that allow for people with Alzheimer’s and their caregivers to learn more about the disease and reduce their feelings of isolation; to ways for people with Alzheimer’s to engage in cognitive training, physical activity, creative writing, and art; to counseling specifically for caregivers to improve their emotional state and physical well-being; to programs that teach skills for health care providers to more seamlessly deliver care to people with Alzheimer’s in a hospital or medical clinic with the goal of reducing depression, stress, readmission to the facility, and delayed placement in nursing homes.
So why aren’t these proven treatments available to people across the country who could benefit from them? Is it because they only work in research studies and not in the real world? Experts at this meeting believe this is not the case. More than 50 studies have been conducted in the U.S. to see whether these treatments can be delivered in the real world and still have the same positive effects. The results give us reason to be hopeful but there is more that needs to be done before we can turn the corner and make them available to everyone.
Over the past 30 years, federal government agencies have provided some funding for the development, implementation, and evaluation of non-drug treatments and care practices for people with Alzheimer’s and their caregivers, like those described above. However, most of the funding has focused on studies about the causes of the disease and medications that can prevent and treat it. Some foundations and associations have provided funding for non-drug treatments and care practices but support from these sources has varied over time. The experts at the June meeting identified these limitations in amounts and predictability of funding as a major barrier to more development, refinement, and use of non-drug treatments and care practices.
For these treatments to truly have more widespread adoption there needs to be more sources of financial support available. Of the 11 treatments presented at the June Meeting, only three of them receive support from Medicare and private insurers, and individuals are paying out-of-pocket to use two of them.
The 2010 health care reform law (Public Law 111.148) authorized many programs that could provide opportunities for expansion and sustainability of non-drug treatments and care practices. One program that could provide financial support for treatments for family caregivers is the Geriatric Education and Training Awards program authorized by Section 5305 the law. This program requires support for Geriatric Education Centers (GECs) to offer at least two courses a year for family caregivers and direct care workers that include training on how to manage behavioral and psychological symptoms of dementia and how to communicate effectively with a person with dementia. Many of the non-drug treatments discussed earlier could be used by GECs.
To learn more about the non-drug treatment and care practices presented at the June meeting, please visit www.agingresearch.org. If you’d like to see a variety of these treatments and care practices available to people with Alzheimer’s and their caregivers, please contact your representative and senators and let them know that by supporting research and implementation of the health reform bill they will be helping us take these treatments the extra mile!