By JULIE MINDA
The number of Americans living with Alzheimer's disease, the most common form of dementia, will more than double in the coming decades. Currently, about 5.8 million Americans ages 65 and up have Alzheimer's disease. By 2050, that count may grow to 13.8 million, according to "2020 Alzheimer's Facts and Figures," a special report published in the March 10, 2020, edition of Alzheimer's & Dementia: The Journal of the Alzheimer's Association.
Panelists in a mid-summer webinar joined the swelling chorus warning that the nation's eldercare system is struggling now with staffing shortages and may be completely unprepared to meet the care needs of baby boomers as they enter advanced old age and develop debilitating diseases of cognition or the inability to perform essential tasks of daily living without assistance.
The panelists said given the anticipated demand for care and assuming continuing difficulties attracting and retaining eldercare staff, they worry about care quality in the future for that vulnerable population of seniors unable to fully care for themselves.
Charles Camosy, an associate professor of theological and social ethics at Fordham University, said the U.S. needs to make the financial commitment to prepare for the coming increase in demand for long-term care, engaging the most creative minds in the country to address the challenge.
Medicaid is the largest single payer for nursing home care. Camosy said advocates should promote increased Medicaid funding, including reimbursements for care provided in people's homes and by family members.
The July 26 webinar, "Dignity and Dementia: Mapping the Church's Response to the Coming Crisis," was sponsored by CHA; New City Press; National Review Institute; the archdioceses of Baltimore, New York, and San Francisco; and the diocese of Orange, California.
The four panelists said the pandemic has laid bare and brought into public consciousness systemic problems including workforce shortages that had festered in some long-term care facilities years before 2020.
Camosy said the staff shortages have led to substandard care in some facilities, with residents warehoused, isolated and medicated as a means of chemical restraint.
Camosy warned that staffing shortages could grow more severe in the future in nursing homes, home care venues and dementia care units in the absence of policy changes that prioritize eldercare.
"Health care providers aren't technicians who have jobs that can be replicated by machines," he said, acknowledging that amassing new resources for eldercare has proven to be an intractable challenge.
Panelist Erin Younkins is an occupational therapist who directs the Office of Life, Justice and Peace for the Archdiocese of Baltimore. She said when COVID infection control protocols barred family visits to nursing home residents for much of last year, patients' quality of life declined.
Family members often pitch in to provide personal care for loved ones in nursing homes and they are a mainstay of emotional support and stimulation. "Nursing homes and assisted living facilities are not set up to provide optimal care when each resident is isolated" as was the case during much of 2020, Younkins said. "In my personal experience, family members frequently were the first to notice wounds, decline in appetite, or other concerning symptoms and report to nursing staff. Without those eyes on the residents, it would be very reasonable to assume a decline in timely care."
Befriend a senior
Panelists explored what the Catholic Church can be doing to support the frail elderly — and particularly those with dementia — living in the community and in institutional settings.
Panelist Bishop Kevin W. Vann oversees the Diocese of Orange, California. That diocese takes part in the Whole Person Care Initiative, an effort by the Catholic Church in California to improve care to the seriously ill. Bishop Vann said parishes around the nation could be organizing programs to teach parishioners how to care for the frail elderly, including those with dementia. California parishes have been doing this for several years.
Panelist Sr. Constance Veit, LSP, is U.S. director of communications for the Little Sisters of the Poor, a congregation serving needy older persons in the homes they run for the elderly. Sr. Veit said that with the medicalization of care in the U.S., many people believe that they are not qualified to aid in the care of the frail elderly. She said the church should dispel the fallacy that only medical providers can tend to the elderly. "There is so much that the average person can do to assist with basic self-care, household tasks and transportation, as well as providing companionship."
Younkins agreed, noting that many isolated seniors crave companionship. "Many of them just want human contact, and it does not take an educational degree to love someone."
Sr. Veit added it's important for people to seek opportunities to draw senior adults out of isolation. She asked: Can you cook together? Can you watch a movie together and discuss it afterwards? Can you ask to learn something from the elder, such as knitting?
Camosy noted that many young adults today are desperately lonely themselves, and spiritually hungry. By spending time with a senior, they could find companionship and broaden their perspective.
"We need to expand how we think of family, neighborhood and community. We need all hands on deck."
"This is the spirit of new evangelization" of demonstrating Christ's love through actions, Camosy said.
Copyright © 2021 by the Catholic Health Association
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