Recently, The Washington Post published an opinion column by Ann Norwich about our unpreparedness for the upcoming dementia crisis. She compared the odds of getting dementia to winning the big Powerball lottery last week. The chances of winning the lottery were 1 in 300 million. Did you also buy a Mega Millions ticket? The chances of winning both were 1 in 8 quadrillion. Those numbers are way beyond unpromising. Yet, were you one of the ones that thought maybe, just maybe, you might hold the winning ticket? You wouldn’t have bought a single one if you didn’t think you had a shot.
Unfortunately, you have much greater odds of developing dementia as you age. Here’s the hard truth:
By the age of 65, you have a 1 in 10 chance of developing dementia.
If you reach the age of 85, your odds go up to 1 in 3.
Despite those alarming numbers, and high probability, most people don’t plan for this eventuality. And we certainly haven’t done so as a nation. Just like it’s a good idea to have an emergency kit in your car, and one at home, it’s a smart idea to have your ducks in a row should your mental capacity decline one day.
Knowledge is power. As individuals, this awareness gives us the opportunity to plan for the future. And as a community as a whole, taking the long view of this impending crisis enables us to enact changes to medical coverage for dementia in its many forms and to put into action better systems of early detection.
As an individual, there are several things you can do to prepare yourself and your family for the possibility of a dementia diagnosis. First up is meeting with lawyers to set up your estate plan, to include financial and health care powers of attorney. That means appointing an agent, usually a family member, who will act on your behalf when you are unable to do so in areas of your finance and health care. We recommend that you can start your research by reading “The 2030 Caregiving Crisis: A Heavy Burden for Boomer Children,” which synthesizes the latest research on baby boomer’s need for caregivers and what options families have going forward.
The earlier you and your loved one’s complete your estate planning, the better. And, if over the years you believe there is a need for change, do it thoughtfully and with careful, professional guidance about the potential outcomes if a challenge to the changes were ever to occur.
Another important document is the advance care directive — the declaration that states your wishes with treatments to prolong your life (i.e., feeding tube, breathing machine, CPR). While we often don’t want to think about the end of our lives, especially when we are healthy, this is a very important topic to address while you can. Not only does it give you say in how you want to spend your last days, but it also provides peace of mind for your loved ones as they are not left with the burden of making these decisions for you. They can rest easy knowing that they are carrying out your wishes. Another document to consider is the designation of guardian in advance of need. This should help eliminate a fight over who is in charge of you and/or your estate in the event you became incapacitated during your lifetime.
A final important piece of this puzzle for individuals is financial and health care planning. With advance preparation, you can assess your finances and make allotments for the expenses of in-home, assisted living or nursing home care. You are also able to do the research yourself on the best services and facilities to use.
Doing all of this planning early, and carefully – in other words, well before there could be a challenge to capacity – is one of the best ways to fend off any challenge based on diminished capacity from age-related dementia and cognitive decline. Otherwise, a will contest as a result of later in life changes may be in your future.
On a much larger level, we have an impending national health care crisis surrounding dementia and Alzheimer’s disease. It’s estimated that there are currently 5.7 million Americans with Alzheimer’s. Unpaid family members typically provide a total of 18 billion hours of care each year, according to the Alzheimer’s Association. And there is a projected 14 million Americans older than 65 who will develop the disease by 2015. The costs of this crisis are staggering.
According to Norwich, the system in which we care for those suffering from dementia is broken. “Our health-care system is grossly unprepared to provide medical care for this cohort of patients. We spend billions of dollars cycling such patients in and out of hospitals and rehabilitation facilities, only to have them return every few months for yet another round of the same,” she shares. “It’s what we know how to do instead of tailoring care specifically for patients with dementia, and many have expressed a desire for something different that enables them to stay at home and receive non-invasive treatments. Unfortunately, many of these patients have not been given the formal diagnosis of Alzheimer’s or another form of dementia.”
A Bloomberg News article stated that early diagnosis could save $7.9 trillion in medical costs over multiple years, especially in the ability to tailor medical care specifically to the needs of the patient. According to Norwich, this includes, but is not limited to, access to medical trials, medications to slow the disease progression, active management of comorbid conditions and the opportunity to engage in goal planning for the future.
It takes courage to face this disease head on. But together we are stronger and walking into the future with our eyes wide open is so much better than sticking our heads in the sand.