Sitting in a state senator's office is not where I would have thought I'd find myself four months ago. However, that's exactly where I was on Tuesday, February 5th, 2019. I was part of a team of 5 people asking our state government to support legislation that could save our state millions of dollars. There were 250 advocates at the capital that day, all asking for the same thing.
Exactly what was this “thing” we were asking for? We were lobbying our representatives to support a bill that was being brought to the floor that afternoon. This bill is to approve funding for a pilot program to educate the population about the warning signs of Alzheimer's. Additionally, this funding will also help achieve early diagnosis of the disease.
Alzheimer’s is the 3rd leading cause of death in seniors in my home state of California. Estimates from the Alzheimer's Association state, quite conservatively, that the average cost of care for seniors living with Alzheimer's, is $341,840. That’s a really low figure, especially in California. Additionally, costs to taxpayers and the state are astronomical.
Diagnosis by a clinician happens in only 45% of people affected with this disease. Many people will not understand what’s wrong with them and end up in the emergency room. We know that emergency rooms are the most expensive place to receive health care. Understanding that many people living with Alzheimer's end up in an emergency room unnecessarily is the reason for the push for early diagnosis.
Introducing the CDCs Healthy Brain Initiative
At the end of the federal congressional budgetary year, the Center for Disease Control came out with a healthy brain initiative. This initiative is a roadmap for local county health departments to roll out an early diagnosis campaign. This campaign would help improve patient outcomes and reduce costs.
Reducing costs and keeping people from receiving health care in the emergency room are two primary goals of this plan. Getting an early diagnosis allows someone living with Alzheimer's to get financial and legal papers in order and plan for the rest of their life. Not knowing you've got a terminal brain disease can cause serious financial hardship because of a lack of planning. While a diagnosis of Alzheimer's is devastating, it is still better than not knowing and being able to plan accordingly.
As a family member of someone who didn't plan well enough, I can assure you that this approach is important. Doctors need to understand why an early diagnosis is important just as much as families.
Implementing the BOLD New Approach
California can lead the way in finding the best way to tackle this challenging issue. As a large, diversely populated state, many of our counties are ideal for this pilot program. The first step would be to develop a coordinated statewide public awareness campaign focused on those at risk of cognitive impairment.
After developing the awareness campaign, local health departments would explore community-based solutions and innovations. Then, assessing local health needs and addressing those with public health interventions comes next. Following this assessment, health departments would target their outreach to at-risk populations and communities. These communities include people of color, Hispanics, and women. Keeping the whole person healthy is important, so collaboration across the patient's life span to include other chronic and disabling conditions is part of the plan. Finally, the health departments would evaluate and replicate the best practices statewide.
This doesn't seem that difficult an undertaking. Obviously, there will be challenges, but I think they can be easily overcome with knowledge, creativity, and just a little money from the state. My team got positive reactions from both legislators' aides, the second one was wildly positive. Now we wait and hope the state grants us the money and we can implement the plan and help families.