Hello, my name is Alice Bonner and I am adjunct faculty at the Johns Hopkins University School of Nursing and welcome to our program today. We are speaking with a colleague about special populations in settings such as assisted living residences. In particular, today we're going to be talking about individuals who are living with dementia or cognitive challenges. With that, I'd like to welcome my colleague, Doug Pace from the Alzheimer's Association. Hi Doug, how are you? Hi Alex, I'm well. How are you today? Excellent, thank you. I'm wondering if you can tell us just a little bit about your title and your role at the Alzheimer's Association as we get started. Sure. Alice, the Alzheimer's Association is the world's largest voluntary health organization dedicated to Alzheimer's and all dementia. Our mission is really focused around three areas, accelerating global research, driving risk reduction in early detection and maximizing care and support, and our vision is a world without Alzheimer's and dementia. My role at the Association, I work out of the home office under our program routine and I work on any issues related to long-term and community-based care. Fantastic, that was great. The first question that I have for you is, every year the Association publishes a Facts and Figures Report. I'm wondering if you can share some of the highlights of that report with us. Absolutely, and I just want to first say that that report is free and downloadable on our website at alz.org/facts. As you say, it's one of the most anticipated reports that we publish every year. Some of the latest facts and figures out of that report shows us that in 2020, over 5 million Americans today are living with Alzheimer's disease. It's the sixth leading cause of death in the US and it's the fifth leading cause of death for persons over 65 and of women of any age. I think it's also important to know that one in three seniors will die with Alzheimer's or another dementia, and the cost around this continues to increase. About 16 million Americans provide unpaid care, and that totals to about $244 billion a year, and then on the paid care side in 2020 were as a country we're going to spend around $305 billion. If you take both of those together in 2020 we're going to be spending over $0.5 trillion between paid and unpaid care to care for persons with Alzheimer's disease. One other quick important notice every year we feature a special report in our Facts and Figures Report in this year's report is looking at the role of primary care physicians. That report is telling us that about 50 percent of primary care physicians really believe that the medical profession, is not ready to deal with the growing number of people that are going to have Alzheimer's and others dementia now and in the future. Great, great facts and figures for everyone listening today. Thank you for that. In particular, in assisted living residences, we understand that the numbers of folks living there who have some cognitive impairment are absolutely going up. Important information, especially as we talk about, infection prevention and pandemics and things like that. You mentioned the associations dementia care practice recommendations and could you tell us a little bit more about those recommendations and why they're important? Absolutely. One of the projects that I was so excited to be a part of when I came to the association about five years ago was updating our dementia care practice recommendations. My colleague, Dr. Sam Fazio and I worked on those for about a year-and-a-half. We've worked with 27 researchers from all around the country in developing a special supplement for the gerontologist. Those researchers developed articles in ten topic areas and then at the end developed five to seven recommendations. Then we wrote up all of those recommendations into 56 recommendations that now provide the foundation of how we believe quality dementia care should be delivered and you should show the next slide. I think what I'd like to do is just, I know it might be a little bit hard to see on the slide, but just to quickly cover those ten topic areas. Alice, one of the things that you and I have been really champions and working on for the past several years is culture change and person-centered care. I'm so excited that the Alzheimer's Association has firmly put our stake in the ground to say that quality dementia care really starts with a person-centered care focus. But those other topic areas are detection and diagnosis. Because again, we know that a large number of people with Alzheimer's and other dementias don't have a diagnosis. Then looking at assessment and care planning and really stressing the importance of a person-centered assessment and those regular care plans, and then from there we talk about medical management. Again, these recommendations are for all health care professionals working in long-term and community-based care settings. Medical management really talks about from that perspective, how do you work with the physician clinician community? Then the next area is information education, and support, and this really it just addresses the issue, of making sure that you meet people where they are, whether they're in the early stage, the middle stage, or the late stage, and matching that information to meet their needs. Of course, one of the most important areas is talking about dementia-related behaviors. What's been exciting about this effect around our dementia care practice recommendations, is now we have more increased evidence to know how we best care for those, as well as looking at activities of daily living. Then, of course, the cornerstone of any good community that's providing care is having a strong workforce. The workforce really talks about, an outline some principles that's really important and having a good stable workforce. Then just coming up in almost finishing this circle, the next area is supportive and therapeutic environments, it's just really stressing how important it is to think about the built environment and how it can best be designed to deal with people with dementia. Then the last area, which is equally important, is transitions, because we know many times that people with dementia are going to be looking at emergency situations where they might need to change a level of care. Again, the exciting thing about what you will see, in the special stuff on the gerontologist is, there's now many evidence-based different types of programs to really help communities in making sure those transitions happen in the smoothest way possible. Fantastic. Wow. That was just a whirlwind of great opportunities, and shows the extent of the work that's been done. I'm wondering if for the final wrap-up question here you could talk a little bit about, the special populations and individuals and how the Alzheimer's Association has helped organizations like assisted living residences, for example, and even some of the community settings with older adults. To be able to work when during this pandemic, COVID-19, or are worried that they may have been exposed to someone with COVID-19. Absolutely. Just, again, to tie all that vacuum to the importance of continuing to have that person centered care focus, I just want to stress that it begins with knowing the person, and out of all over 56 recommendations we start with that focus. Then once you do that, then you can make the person in their own reality, and then you create that meaningful engagement with them and then that creates that relationships to have that supported community. But yes, as we had it into the spring of this year and communities started experiencing COVID and dealing with that and how they kept the rest and safe and how they kept their staff safe. One of the things that we did, and I believe there's a slide that talks about the topic areas of our emergency preparedness guidelines, it's just really having the importance of making sure even during emergency situations, that communities still have that focus of person-centered care. That they're really focused on preventing illness and they're really focused on things like handwashing and social distancing. But also is important as well is, really the importance of keeping families and friends connected. Thinking around things like hydration and nutrition, which are always so important, because now residents especially in assisted living, in nursing homes, have lost much of the social aspect of what that care is all about. Thinking about things like that and then also making sure that they have opportunities to exercise and they're out there in nice spaces, and then that staff is able to observe and respond to those that work as well. We do that work and spread that out to everyone, but then we also have a group called a Dementia Care Provider Roundtable, where we bring together some of the leading providers from around the country, to really focus on those issues and help us with that. I'm really excited to announce, they just recently had an article published in Cheddar that really talks about the focus of person-centered care, and how best to deal with that during the COVID-19 pandemic. Fantastic. Well, I think we covered a lot of ground today, Doug. Thank you so much for joining this course. I think this session will really tie in this tremendous work that the Alzheimer's Association has been doing all across the country, and you tied it up really well with the pandemic and the challenges that many assisted living residences are working through right now with the COVID-19. We want to thank you for the ongoing work that we know you're all doing. To those of you who are listening in today to this session, thank you very much for joining and we look forward to seeing you at another session again soon. Take care. Thanks so much.
