puzzle with missing piece--Alzheimer's Disease

A 2021 update to the National Plan to Address Alzheimer’s Disease includes actions to examine the use of informal caregivers and states’ progress in rebalancing Medicaid long-term care toward home-and community-based services (HCBS).

The plan, which is an outgrowth of the 2011 National Alzheimer’s Project Act, is designed to address the major challenges presented by Alzheimer’s disease and Alzheimer’s disease-related dementias. One of the goals of the plan is to prevent and effectively treat Alzheimer’s disease and related dementias by 2025.

Among the new actions in the plan — which underwent its ninth update in late December — is to model future expenditures on long-term services and supports (LTSS) and the use of informal caregivers. As many Americans must impoverish themselves to receive Medicaid for LTSS, it could drive up federal and state LTSS spending, the Office of the Assistant Secretary for Planning and Evaluation said in the Dec. 27, 2021, update. “As such, there is a pressing need to understand the current cost of long-term care, national expenditures on LTSS, and future projections of the availability of informal caregivers,” the office said.  

One of the main goals of this action is to provide estimates of the value of informal caregiving, projections showing how changing demographics may affect older Americans’ need for LTSS, the supply of future caregivers and Medicaid spending, the office said.

The office also plans to assess the extent to which states have rebalanced Medicaid-funded LTSS from institutional LTSS to HCBS between 2015 and 2019. Analyses will involve identifying characteristics of state LTSS programs with greater rebalancing toward HCBS. The project also will see which states’ use of HCBS is effective in preventing or postponing long-stay nursing home care.

Other new actions in the plan include researching the impact of COVID-19 on the risk of Alzheimer’s disease/Alzheimer’s disease-related dementias, cognition and brain health; increase access to hearing aids for those with hearing loss; lowering sodium in the food supply to improve nutrition; and enhancing public messaging on blood pressure control.