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Alaska Commission on Aging 2008 Senior Data Presentation

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Alaska Seniors by Gender and Age Group ... The vast majority of seniors age 65 are covered by Medicare. ... Seniors make up only a small segment of Medicaid ... – PowerPoint PPT presentation

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Title: Alaska Commission on Aging 2008 Senior Data Presentation


1
Alaska Commission on Aging 2008 Senior Data
Presentation
  • Presented to the
  • Alaska Mental Health Trust Authority
  • May 29, 2008

2
Our Purpose
  • The mission of the Alaska Commission on Aging is
    to ensure the dignity and independence of all
    older Alaskans, and to assist them, through
    planning, advocacy, education, and inter-agency
    cooperation, to lead useful and meaningful lives.

3
Alaska Commission on Aging Commission Members
  • Banarsi Lal, Chair
  • Sharon Howerton-Clarke, Vice Chair (and FY 2009
    Chair-Elect)
  • Frank Appel, Public Member
  • Pat Branson, Provider Member
  • Tara Jollie, Department of Commerce, Community
    Economic Development Designee
  • Betty Keegan, Public Member
  • Iver Malutin, Public Member
  • Rod Moline, Director, Senior Disability
    Services, DHSS Designee
  • Paula Pawlowski, Public Member
  • Ed Zastrow, Chair, Pioneer Home Advisory Board
  • Staff
  • Denise Daniello, Executive Director
  • MaryAnn VandeCastle, Planner II
  • Lesley Bullock, Planner I
  • Sherice Ridges, Administrative Assistant

4
Purpose of Presentation
  • The intent of this presentation is to provide an
    overview of the status of Alaska seniors living
    with Alzheimers Disease and Related Dementias
    (ADRD), including their estimated numbers,
    characteristics, and the types of services
    available.

5
Alaska Senior Demographics
6
A Growing Population of Seniors
  • Alaskas age 60 population grew by 43 between
    2000 and 2007.
  • Our senior population is growing faster than that
    of any other state except Nevada.
  • Data Source Alaska Department of Labor
    population estimates, 2000-2007

7
Alaska Seniors by Gender and Age Group Data
Source Alaska Department of Labor 2007
population estimates (2008)
8
Seniors represent all regions of the state.
Map Alaska Dept. of Health Social Services
regions Data Source Alaska Dept. of Labor 2007
population estimates (2008)
9
And they come from all races, though over 75 are
white. Data Source Alaska Dept. of Labor 2006
population estimates (2007)
10
The vast majority of seniors age 65 are covered
by Medicare. Medicare Figures Centers for
Medicare and Medicaid Services Senior Population
Estimates Alaska Dept. of Labor, 2001-2005
11
Alzheimers Disease and Related Dementias (ADRD)
12
ADRD reflects a number of profound changes in the
brain. Source Alzheimers Association 2008
13
Related Disorders Include
  • Vascular Dementia
  • Mixed Dementia (Alzheimers Disease Vascular
    Dementia)
  • Parkinsons Disease-Associated Dementia
  • Wernicke-Korsakoff
  • Picks Disease
  • Lewy Body Dementia
  • Huntingtons Disease (or Creutzfeldt-Jakob
    Disease)

14
Alzheimers is a disease.
  • Its not a normal part of the aging process.
  • Alzheimers is the result of a disease process
    and is fatal.
  • Source
    Quadagno 2005

15
Alzheimers Disease Versus Normal Changes in
Memory
  • Normal Aging
  • Forgetting to set the alarm clock
  • Forgetting someones name and remembering it
    later
  • Forgetting where you left your keys and finding
    them after searching
  • Forgetting where you parked your car
  • Possible AD
  • Forgetting how to set the alarm clock
  • Forgetting a name and never remembering it, even
    when told
  • Forgetting places where you might find your keys
  • Forgetting how you came to be in a particular
    location
  • Source Hooyman Kiyak 2002

16
Stages of Alzheimers Disease
  • Stage 1 Normal Function
  • No cognitive problems noted by individual or
    medical provider.
  • Stage 2 Very Mild Cognitive Decline
  • Complaints of mild forgetfulness and some
    work difficulties difficulty finding the right
    word
  • Stage 3 Mild Cognitive Decline
  • Problems with concentration, some difficulty
    at work and in traveling alone
  • Source Alzheimers Association 2008

17
Stages of Alzheimers Disease
  • Stage 4 Mild or Early-Stage Alzheimers Disease
  • Late confusion stage increased denial of
    symptoms withdrawal
  • Stage 5 Moderate or Mid-Stage Alzheimers
    Disease
  • Poor recall of recent events needs
    assistance with dressing and bathing
  • Source Alzheimers Association 2008

18
Stages of Alzheimers Disease
  • Stage 6 Severe, Mid Stage Alzheimers Disease
  • More memory problems more assistance needed
    with Activities of Daily Living (ADLs) more
    personality changes
  • Stage 7 Very Severe or Late-Stage Alzheimers
    Disease
  • Loss of language loss of ability to walk
    incontinent may become comatose
  • Source Alzheimers Association 2008

19
Suggested Practices Caring for Persons with ADRD
  • Emphasize familiarity and routine to build trust
    and comfort
  • Maintain clear, concise, calm communication
  • Pay attention to nonverbal communication
  • Limit Distractions
  • Long term memory last to be impaired
  • Focus on individuals abilities, strengths, and
    preferences. Allow them to continue to do what
    they can to convey respect and dignity.
  • Keep tasks simple
  • Exercise patience and understanding
  • Sources Hooyman Kiyak 2002
  • Quadagno 2005

20
As of 2007, over 5,000 Alaskans are estimated to
have ADRD. Source ACoA estimate
based on national prevalence data
21
Death rates related to Alzheimers disease are on
the increase in Alaska. Source Alaska Bureau of
Vital Statistics 2005 Annual Report
22
The number of Alaskans with ADRD is projected to
nearly quadruple from 2000 to 2030. Sources
Population projections by Institute of Social
Economic Research (2007) and national ADRD
prevalence rates by age group
23
Based on the Behavioral Risk Factor Surveillance
System (BRFSS) for Alaska
  • Older Alaskans may be at slightly lower risk for
    ADRD in light of their lower rates of various
    cardiovascular risk factors they also have
    higher rates of some protective lifestyle
    factors than older Americans in general.

24
Slightly fewer older Alaskans have had a heart
attack.
25
Older Alaskans suffer from a slightly lower rate
of coronary heart disease.
26
Slightly fewer older Alaskans have had a stroke.
27
Slightly fewer older Alaskans have high
cholesterol.
28
Older Alaskans are significantly more likely to
engage in moderate or vigorous physical activity.
29
And older Alaskans are slightly more likely to
eat a healthy diet, as measured by the number who
eat at least five fruits and vegetables per day.
30
An ACoA survey of the publics knowledge of ADRD
and the lifestyle factors which may prevent it
showed that Alaskans are already fairly
well-informed.
31
But some survey responses point to the need for
further community education.
32
The Continuum of Long-Term Supports In Alaska
  • Congregate meals
  • Public transportation
  • Information/referral/ personal advocacy
  • Physical fitness programs
  • Health promotion/ disease prevention classes
    activities
  • Senior employment services
  • Independent living
  • Senior centers
  • Senior volunteer programs
  • Legal services
  • Health screening
  • Social recreational activities
  • Community-Based Services (appropriate for all
    seniors, including ADRD stages 1 and 2)

33
The Continuum of Long-Term Care in Alaska
  • Home-Based Services (appropriate for homebound
    seniors and those needing extra support,
    including ADRD stages 3, 4, and 5
  • Home-delivered meals
  • Assisted transportation
  • Shopping assistance
  • Congregate housing
  • Supported housing
  • Home repair and renovation
  • Senior companion volunteers
  • Homemaker/chore service
  • Companion programs

34
The Continuum of Long-Term Care in Alaska
  • Intensive Home- and Community-Based Services
    (appropriate for those with intensive health
    needs or ADRD stages 5 and 6, as well as their
    caregivers)
  • Adult day services
  • In-home respite care
  • Home health care
  • Personal care
  • Hospice care
  • Family caregiver support
  • Outpatient care
  • Rehabilitation
  • Counseling

35
The Continuum of Long-Term Care in Alaska
  • Services in a Residential Care Setting
    (appropriate for ADRD stages 5, 6 and 7)
  • Assisted living
  • Facility respite care
  • Pioneers Home
  • Adult foster care

36
The Continuum of Long-Term Care In Alaska
  • Institutional Services the most intensive level
    of care, appropriate for ADRD stages 6 and 7
  • Acute care
  • Nursing home care
  • Residential hospice care

37
Services for Alaskans with ADRD
38
State Services for ADRD Seniors
  • Pioneer Homes
  • Assisted Living Facilities (Licensed)
  • Medicaid Waiver Program
  • Personal Care Assistance (PCA)
  • Senior Grant Programs

39
More than half the residents of Alaskas Pioneer
Homes are diagnosed with ADRD. Source Alaska
Division of Pioneer Homes
40
Most Pioneer Home residents with ADRD require the
highest level of care.
41
Who are the Pioneer Home residents with ADRD?
  • Gender Marital Status
  • 70 Female 50 Widowed 11 Single
  • 30 Male 21 Married 7 Unknown
  • 11 Divorced
  • Race Age
  • 91 White Average age 86 years old
  • 6 Native Average age of admit by year
  • 1 Asian 1998 76 years
  • lt1 Black 2003 84 years
  • 2 Unknown 2008 86 years

42
Licensed assisted living beds vary widely by
region. Source Alaska Division of Public
Health, Alaska Health Care Data Book Selected
Measures DHSS 2007
43
Projected increases in the cost of nursing home
and assisted living care over the next 20 years
are daunting. Source Genworth Financial 2008
Cost of Care Survey
44
Seniors make up only a small segment of Medicaid
beneficiaries in Alaska. Source Financial and
Management Services, Medicaid Budget Group,
Alaska DHSS Alaska Health Care Data Book Selected
Measures, DHSS 2007
45
Medicaid-eligible individuals who meet level of
care requirements may qualify for one of four
Medicaid waivers through SDS. Source Senior
Disabilities Services Alaska Health Care Data
Book Selected Measures, 2007
46
Older Alaskans waiver recipients are found in
every region. Source Senior Disabilities
Services 2007 Alaska Health Care Data Book
Selected Measures, DHSS, 2007
47
A substantial number of PCA and Medicaid waiver
participants have ADRD in addition to meeting
income requirements, waiver eligibility is based
on diagnosis and functional assessment. Source
Senior Disabilities Services
48
The largest group of PCA and waiver recipients
with ADRD are those in their 80s. Source Senior
Disabilities Services
49
Another much larger group of seniors receives
senior grant services, many of which have no
income limitations. Source Senior
Disabilities Services Alaska Health Care Data
Book Selected Measures, DHSS 2007
50
Grant recipients take advantage of a wide range
of Nutrition, Transportation, and Support
services although not all are available to
completely meet demand in each community.
Source Senior Disabilities Services
51
Grant services recipients are diverse in age,
race, gender, type of community, and income level.
52
Priority Issues for Alaskans with ADRD
  • Access to primary health care
  • Addition of a Medicaid waiver for individuals
    with ADRD
  • Additional funding for senior grant services for
    the 80 to 85 percent of seniors who are not
    eligible for the Medicaid waiver
  • Continued statewide long-term care strategic
    planning, including a plan for the future of the
    Pioneers Homes

53
Thank you.
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