Alzheimer’s boom looming

Half of all baby boomers who hit 85 expected to suffer from disease

It’s a startling calculation.

By the time today’s baby boomers turn 85, one of every two will have Alzheimer’s disease.

“That assumes there isn’t some kind of medical breakthrough that leads to a cure before then, but, yes, that’s what the numbers show,” said Lou Saadi, director of the Office of Health Care Information within the Kansas Department of Health and Environment.

A recent KDHE study found that the number of patients diagnosed with Alzheimer’s after being admitted to a Kansas hospital increased 20 percent between 1999 and 2003 – 11 percent for men, 25 percent for women.

It’s not unusual, Saadi said, for an elderly person to be hospitalized for an unrelated ailment – a broken hip, for example – and for doctors to realize the patient also has Alzheimer’s.

“Some of this increase may be driven by more people going to the hospital rather than an increase in the Alzheimer’s rate,” Saadi said. “It’s something that needs more study.”

‘The doorstep of a crisis’

Still, no one denies that troubles associated with Alzheimer’s are increasing as the number of elderly Kansans continues to rise.

Debbie Jennings, Lawrence, spends a lot of time with her father, Bill Davison, at Pioneer Ridge Retirement Community. Davison has suffered dementia since suffering a stroke several years ago. The photo in the foreground shows Jennings and her father in happier days at the family farm.

“We are standing on the doorstep of a crisis, knocking on the door,” said Rep. Bob Bethell, R-Alden, a member of the House budget and health care committees.

Kansas’ population is one of the nation’s oldest and, consequently, one of the most vulnerable to Alzheimer’s.

According to the U.S. Census Bureau, the number of Kansans age 85 or older:

¢ 1970 – 22,828.

¢ 1980 – 33,453.

¢ 1990 – 42, 241.

¢ 2000 – 51,770.

Douglas County had 1,028 residents who were 85 or older in 2000; Lawrence had 442.

Already, more than half the 20,000 residents of Kansas nursing homes have Alzheimer’s or comparable forms of dementia.

“It’s between 50 and 60 percent,” said Debra Zehr, executive vice president at Kansas Association of Homes and Service for the Aging.

One family’s experience

Debra Jennings, of Lawrence, her mother, Lorene Davison, and her sister, Diana Dexter, help take care of her father, Bill Davison, a resident of Pioneer Ridge Nursing Home.

He suffered a stroke about five years ago, she said, and the family has banded together to help him and each other cope with his dementia.

“My family, we all kind of lean on each other to get through this. We’re lucky that we’ve been able to work through it with each other,” Jennings said. “It’s brought us closer together.”

Most nursing home residents’ stays are underwritten by Medicaid, a 40/60 blend of state and federal funds, depending on how quickly their finances are depleted.

“I don’t have a number that’s tied to dementia per se,” Zehr said, “but right now, somewhere between 55 and 60 percent of the people in nursing facilities in Kansas are on Medicaid.”

At $2.2 billion annually, Medicaid is the state’s second-largest expense next to spending on public schools.

Controlling Medicaid costs

Lawmakers have openly fretted over how to rein in Medicaid costs, which have doubled in the past 10 years.

Earlier this month, Kansas Senate President Steve Morris, R-Hugoton, called Medicaid spending “the most critical issue facing the state.”

“It all goes along with the ‘age wave,'” Zehr said. “The fact that more and more people are reaching age 85 and that half of these people have or will have some form of dementia just exacerbates the issue: How are we going to pay for all this?

Debra Jennings kisses her father, Bill Davison, while visiting him at Pioneer Ridge Retirement Community.

“And this doesn’t even address support for caregivers in the home,” Zehr said. “We know that the largest percentage of long-term care is delivered by a person’s daughter or spouse. It’s a tremendous burden on them – without them, it will be a tremendous burden on taxpayers as well.”

Pilot programs proposed

Last year, Zehr urged lawmakers to launch pilot projects aimed at changing the state’s approach to long-term care, especially in rural areas where services are sparse.

“There wasn’t much response,” she said.

Bethell said that’s because Medicaid regulations have tied the state’s hands.

To try something new the state would have to apply for a Medicaid waiver. But these waivers, Bethell said, cannot include higher rates.

Already, rates paid to Medicaid providers in Kansas – doctors, hospitals, pharmacies, nursing homes – are among the lowest in the nation.

“Whatever we do will have to be revenue-neutral,” he said.

Bethell said he’s also worried that coming up with new, same-cost services would do little to control costs because demand would surely increase.

“That’s what causes waiting lists, and we don’t want that,” he said.

Changes are needed

But the state can’t keep providing services the way it always has, Zehr said.

“This is a major concern for us,” she said. “We have rural areas in the state where there’s one nursing home in the county – it’s the only service provider, but it’s barely making it.

“We’d like to see some pilot projects that would allow these facilities to become centers for all kinds of aging services,” she said.

These services, she said, would help families care for relatives with Alzheimer’s in or near their homes.

Whether the Legislature embraces Zehr’s proposals remains to be seen.