Policy on Alzheimer’s Sends Mixed Message

By: Sanford R. Altman, Esq.

Working with so many seniors and their families and caregivers, I like to keep a close eye on Washington and Albany to see how their actions or – or lack of action – affects my clients.

I look at trends and overall policy, seeking hints at what we might expect for the future.

But when it comes to policies on Alzheimer’s disease, I have to admit, I am stymied. A look at some of the facts about this devastating disease may explain why.

A top killer of Americans

According to the Alzheimer’s Association fact sheet of March, 2013, Alzheimer’s disease is this nation’s sixth-leading cause of death and the second largest contributor to death among older Americans, second only to heart failure.

It currently afflicts more than five million Americans, savaging their ability to act, reason and even recognize their loved ones.

It is the only cause of death among the top 10 without a way to prevent it, cure it or even slow its progression.

In the 10 years from 2000 to 2010, while there have been decreases in deaths from breast cancer, prostate cancer, heart disease, stroke and HIV, there has been an 68 percent increase in deaths from Alzheimer’s disease.

Since many with Alzheimer’s can linger for years, needing very expensive nursing home care or even more-expensive care at home, it would seem that the logical conclusion for those who are watching our budget would be to do whatever it takes to stop the financial bleeding. This should be the case even without taking into account the massive human toll and the years of suffering.

But instead, there appears to be a mixed response.

Here is an example:

The Affordable Health Care Act provides that Medicare will pay for annual health visits to your medical provider.

Mild neuro-cognitive impairment will be included in this annual exam paid for by the government.

In essence, they are saying that early diagnosis is vital enough for the government to pay for it. This certainly makes sense.

Early diagnosis is essential

Let’s look at the other side of the coin.

There have been two recent extremely important developments related to dementia.

First, the substance beta amyloid in the brain has been scientifically linked to those who have dementia such as Alzheimer’s disease.

Second, PET scans can now identify the presence of amyloid plaque in the brain long before symptoms become apparent. In other words, early detection is possible.

It would seem logical that, since the government has committed to cover tests for early detection, it would certainly pay for the PET scan. However, the federal Centers for Medicare and Medicaid Services has just denied coverage for this test.

Donna Davies, tireless care consultant for the Alzheimer’s Association of the Hudson Valley, stressed the importance of early diagnosis, since it provides greater opportunity to benefit from treatment, and also gives people time to make decisions about their future.

Make your voice heard

I often tell my clients that elder law planning is part law and part health.

It can change dramatically as we go along and health changes. Think of the great benefit of knowing well in advance that one is at risk for dementia. In fact, the reverse, a negative result in a PET scan, might have even more impact. Knowing that your difficulties with your memory are not, in fact, early-onset Alzheimer’s can make a dramatic change in your doctor’s treatment, not to mention your lawyer’s planning.

While the inconsistencies in governmental policy probably do not surprise anyone, we do have another opportunity coming up to be heard on the importance of these issues.

From today through Oct. 27, at five locations here in the Hudson Valley, the annual Walk to End Alzheimer’s will be held.

Please call 1-800-272-3900 or go online to alz.org/walk to participate and let your voices be heard.

Please join us!

This article was originally published in the Times Herald Record on September 22, 2013.