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Primary Care Physicians Worried About Adequacy of Dementia Care

In comprehensive report, more than half say there aren't enough specialists; unpaid caregivers also report strain

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About half of primary care physicians say the health care system is unable to provide adequate care for many of the country's 5.8 million Alzheimer's patients — even as the number with the disease ramps up, according to a new report detailing the status of Alzheimer's in the United States. In addition, the report sheds new light on the challenges faced by unpaid caregivers, who provide the bulk of help to dementia patients.

In its “2020 Alzheimer's Disease Facts and Figures” report on the state of the disease, the Alzheimer's Association reveals that primary care physicians (PCPs) are worried about both current and future treatment of dementia patients.

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A survey of PCPs found that 82 percent “say they are on the front lines of providing dementia care.” Nearly half (45 percent) believe that the medical profession is “not very prepared” to care for Alzheimer's and other dementia patients, and 5 percent say they are “not at all prepared,” according to the report. Looking at their own regions, 49 percent said there are “not enough specialists” on Alzheimer's to meet patient demand. An additional 6 percent said there are “almost no specialists” available locally.

The report found that while there has been an uptick in the number of geriatricians, “trends in medical training also point to a growing shortage."

"The workforce to care for the older population is currently, and is likely to continue to be, inadequate,” the report asserts.

The report also addressed the issue of unpaid caregiving. More than 16 million family members, friends and other unpaid caregivers provide care, the association says, amounting to 18.6 billion hours in 2019. The association estimates the total value of unpaid caregiving during last year was $244 billion.

Among the other caregiving findings:

  • Compared with those who provide caregiving for people without dementia, twice as many caregivers for those with dementia “indicate substantial emotional, financial and physical difficulties."
  • About 3 in 5, or 59 percent, of dementia caregivers rate their emotional stress due to caregiving as high or very high.
  • More than half (53 percent) of female caregivers with children under age 18 believe that dementia caregiving “was more challenging than caring for children."
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According to the association's most recent figures, 5.8 million people in the country ages 65 and older have Alzheimer's. Broken down by decades, 3 percent of 65- to 74-year-olds, 17 percent of 75- to 84-year-olds and 32 percent of adults 85-plus have dementia.

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For someone age 65 today, the lifetime risk for Alzheimer's is 11.6 percent for men and 21.1 percent for women. By 2050, the association projects that 13.8 million people in the U.S. will have Alzheimer's, more than doubling the total number of cases in the next three decades.

Although it is less frequently cited as the actual cause of death, about 1 in 3 older adults die with Alzheimer's or another dementia.

Bolstering the physicians’ belief that those caring for dementia patients are battling strong headwinds, a little more than half of caregivers (51 percent) “report having no experience performing medical/nursing-related tasks, and they often lack the information or resources necessary to manage complex medication regimens."

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