UCLA program alleviates Medicare costs, addresses multiple dimensions of dementia
The UCLA Alzheimer’s and Dementia Care Program has served approximately 2,700 patients and their families since the program began. The program collaborated with other community programs in Los Angeles, including adult day care centers, caregiver education programs and counseling services, to provide patients with services beyond typical medical care. (Daily Bruin file photo)
By Celia Janes
Jan. 14, 2019 12:36 a.m.
This post was updated Jan. 21 at 2:35 p.m.
A UCLA program has decreased costs for Medicare and provided benefits for dementia patients through partnerships with community organizations.
The UCLA Alzheimer’s and Dementia Care Program has helped Medicare save nearly $2,500 per patient annually and delayed nursing home admissions for patients, according to a study conducted at the program. This has allowed patients to live at home for longer periods of time. The program collaborated with other community programs in Los Angeles, including adult day care centers, caregiver education programs and counseling services, to provide patients with services beyond typical medical care.
David Reuben, chief of the Division of Geriatrics at the David Geffen School of Medicine at UCLA and the program’s director, said trained caregivers have played a central role in the program’s success. Dementia care specialists, specially trained nurse practitioners, are trained to address the complicated interactions of social, medical and behavioral issues associated with dementia.
The nurse practitioners can provide medical care and reach out to the community to provide support for individual patients. Zaldy Tan, the medical director of the seven-year-old program, said they are crucial to the program’s success.
“They become the bridge between the medical system and the community,” Tan said.
Michelle Panlilio, one of the three dementia care specialists within UCLA’s program, said they have served approximately 2,700 patients and their families since the program began. She added that addressing both the social and medical effects of dementia helps provide a more holistic treatment for patients.
“Our program is vital because dementia will touch every person in society, whether someone is diagnosed themselves or have a loved one who develops this diagnosis,” Panlilio said.
Tan said he thinks the program’s partnerships allow patients to take advantage of different resources in the UCLA community to enhance their holistic care. Many needs of dementia patients, such as social support and caregiver education, cannot be met in a medical center alone, he added.
“We realize that we can address the medical needs of people with dementia who come to UCLA, but not their entire needs,” he said.
The program has formed partnerships with local groups to provide care beyond just medical treatment. Tan said they identified key partners in the community, such as Alzheimer’s Los Angeles and WISE & Healthy Aging, to provide comprehensive dementia care. This allows them to provide more treatment that emphasizes the social benefits of familial support, which delays nursing home admissions.
Tan said both patients and caregivers benefit from the program. His research has found that participation within the Dementia Care Program helps mediate patients’ behavioral issues. Decreased lengths of stay and improved health outcomes may also decrease Medicare costs. Reuben said caregivers also benefit because their community partnerships reduce the pressure of their jobs, causing their stress levels to go down and their self-efficacy to increase.
“It views the person with dementia and the caregiver as a dyad,” Reuben said. “Both need support and care.”
Tan said more people are at risk to develop Alzheimer’s disease or dementia nowadays, due to increased life expectancy in the U.S. In addition, he said these illnesses remain underdiagnosed because early symptoms, such as forgetfulness, are often associated with and dismissed as stages in the typical aging process.
Reuben said he hopes the program’s model will spread to other health care programs around the country. Reuben, Tan and other UCLA researchers will continue to look into how lifestyle changes can impact people’s’ risk for Alzheimer’s and dementia and help benefit those who have already been diagnosed with the disease. While they do not expect to find a cure, researchers are looking to stop the disease’s progression.
“Our ultimate hope is that we will find a way to prevent, treat or halt the condition,” Tan said.
