Guess how many Americans are currently working as unpaid caregivers for someone with Alzheimer’s or another form of dementia?
The answer, says the Alzheimer’s Association, is 11 million. There are 6.5 million people currently living with — and dying of — dementia.
To put this in context, there are more unpaid dementia caregivers in the U.S. than there are paid medical professionals, which total 9.5 million, including doctors, nurses and medical technicians.
The number of unpaid dementia caregivers is greater than the total number of teachers in America (9.4 million). It’s more than 10 times the number of lawyers (830,000) and nearly 20 times the number of barbers and hairdressers (620,000).
Dementia is the pandemic that rarely gets the headlines it merits. The numbers are huge and rising. The costs — emotional and financial — are crippling, and they pose yet another rising challenge for the U.S. healthcare system and for Medicare and Medicaid, both of which are facing incipient crisis.
So a recent pilot program run by two U.S. universities — the University of California, San Francisco, and the University of Nebraska — is news, or should be.
By providing team-based support by phone and online, the program managed to produce significantly better healthcare outcomes both for the patients and their caregivers. And, maybe just as important, it slashed the costs to the medical system.
We are talking a lot of money, too. During a single year, the average cost to Medicare for those in the program was $6,300 less than for those not in the program. That was due, for example, to fewer trips to hospital emergency rooms for patients and to lower costs related to treating caregivers for depression. The program itself cost less than $1,300 per beneficiary.
Multiply those numbers by millions and, as they like to say in Washington, pretty soon you’re talking about real money.
The program also produced higher quality-of-life scores for people with dementia.
The program, called the Care Ecosystem, focused mainly on providing caregivers with “phone-based collaborative dementia care.” It involved both proactive and responsive help from professional care coordinators, nurses, social workers and pharmacists. The some 500 pairs of dementia patients and caregivers who received the support were compared with a control group.
The results have been published in the Journal of the American Medical Association.
As the researchers point out, the results are comparable to, but even better than, those of similar projects.
The Biden administration is currently preparing a trial program, called Guiding an Improved Dementia Experience, or GUIDE, that will operate along similar lines. It is scheduled to be up and running in July of next year and to run for eight years.
It is not news that the U.S. faces an “entitlements” crisis, meaning that there are big holes in the accounts of Social Security and Medicare. In the case of Social Security, there is no magic bullet: The program consists of money coming in and checks going out to beneficiaries, and there is no way of filling the hole except by raising taxes or lowering benefits. But Medicare is different. The program currently spends $1 trillion, and that amount is expected to rise by 50% more than gross domestic product over the next decade and a half. But that money goes toward medical treatments, so if the healthcare system can produce the same or better outcomes for less money, then that’s straight savings.
This pilot program has produced remarkable gains just by scratching the surface. While one should never make predictions, especially about the future, here’s one you can take to the bank. There’s going to be a bull market in medical efficiency, and it’s going to run and run.