This year, the Alzheimer’s Association is taking a closer look at Mild Cognitive Impairment (MCI) and encouraging greater awareness and understanding of this condition and its relation to Alzheimer’s disease.
Here are some of the top takeaways:
More than 6 million Americans are living with Alzheimer’s
1 in 3 seniors dies with Alzheimer’s or another dementia
In 2020, COVID-19 contributed to a 17% increase in Alzheimer’s and dementia deaths
More than 11 million Americans provide unpaid care for people with Alzheimer’s or other dementias and in 2021, these caregivers provided more than 16 billion hours of care valued at nearly $272 billion.
Fewer than 1 in 5 Americans are familiar with mild cognitive impairment (MCI), which can be an early stage of Alzheimer’s
About one-third of people with MCI due to Alzheimer’s disease develop dementia within 5 years of diagnosis
When the pandemic first took hold in America, the bulk of cases were in urban areas, like New York City. I remember at the time reading some opinions from those in rural areas of the country, who thought that being a spread out population would protect them from the coronavirus. While that may have protected them somewhat during the early period of the pandemic, the trend have now reversed, with rural areas of the country being overwhelmed by an influx of COVID-19 cases.
Vaccine hesitancy and the political influence of anti-vaxxers and covid deniers in rural America is playing a role in the rise of cases from the delta variant, but that is not the whole story. What we are witnessing are the critical deficiencies in the rural healthcare system. People are dying needlessly because there is not enough space, supplies and staffing to care for them. With the country’s elder population increasing over the next decades, this is an issue that needs prompt attention.
I witnessed the challenges facing those needing medical care in rural areas when I was a caregiver for my parents. There were no memory care facilities with available beds nearby, so my father was transferred to Roswell, over an hour and a half away. This placed a huge burden on my mother when trying to visit him, as she didn’t drive and had to take a bus to make the trip. She was so tired after one grueling trip that she fell in the middle of the night and broke her shoulder. When my father became critically ill, he was transferred all the way to Albuquerque, a three-hour trip from where my parents lived. He died without family present, as my mother was preparing to visit him.
When my mother became ill, the local hospital was unable to perform her surgery, so they transferred her to Roswell. She spent the summer there, recuperating from surgery at a skilled nursing facility. Instead of making the trip back and forth to my parents’ home in Ruidoso, I lived out of a hotel in Roswell for that summer, a pricey endeavor but I learned how important it was for me to be a hands-on caregiver advocate for my mother during that recovery period. Her follow-up care had to be carefully arranged once she got back home, because the oncologists only visited Ruidoso a few days a month. After she died, I learned that the oncologist group discontinued serving the area, forcing those with cancer to travel an hour and a half away for treatment.
Many rural hospitals have closed. Equipment and beds are limited. It’s difficult to recruit doctors and nurses to serve in rural areas. Ambulance services have also been impacted, meaning people die because they can’t get to a hospital fast enough. Specialty services and tests often require lengthy travel, a burden for many families. You can see how these issues create a perfect storm when a pandemic strikes. Many rural healthcare systems now find themselves at the breaking point.
People should be able to age in place where they wish, but they should also be aware of the challenges in aging in a rural area. It will take a mix of public and private funds along with innovative minds to fix the issues plaguing the rural healthcare system, but it is essential and we must take the hard lessons learned during these times to advocate for change.
This week, the Biden administration announced that nursing home workers employed at facilities receiving Medicaid or Medicare funding will be required to be vaccinated against COVID-19. The ruling will have a wide impact, as many nursing homes across America rely upon government funding. As of now, approximately 40 percent of nursing home workers remain unvaccinated.
The decision, while not entirely unexpected, is drawing a mixed reaction. To give you an overview, here are some of the
Some nursing home administrators welcome the ruling, because they want all of their workers vaccinated and feel this might offer the incentive for those who have been reluctant to do so.
Other nursing home owners fear that they will lose a critical amount of their workforce, as those who are adamant about not getting the vaccine will leave for fields that do not require vaccination.
Still others feel the ruling is incomplete and doesn’t go far enough. They want to see all healthcare workers be included in the vaccine mandate, instead of nursing home workers being singled out.
Some nursing home administrators are calling for a more robust educational campaign from the federal government to answer the questions that their vaccine hesitant workers have as part of the vaccine requirement ruling.
My opinion is that our most vulnerable population deserves to be treated by those willing to provide the safest care possible. With the highly infectious delta covid variant currently impacting the country, I don’t believe it is safe for workers or nursing home residents to remain unvaccinated. For families paying several thousand dollars per month for their loved one’s care, asking staffers to take precautions to maintain workplace safety is not unreasonable. With companies like Disney mandating their employees be vaccinated, it shouldn’t be controversial that healthcare workers would be expected to do the same. But we are living in extraordinary times, and there have been several high-profile protests at healthcare facilities around the country, with workers pushing back against mandatory covid vaccinations.
I do fully support individuals having autonomy over their bodies. If a person chooses to decline the covid vaccine, there are plenty of jobs available that do not require the vaccine and do not involve direct contact with vulnerable populations. The concerns about a nursing home staffing shortage are legitimate, but staffing was an issue well before the pandemic, due to the low wages and little to limited benefits offered by the industry. I support a better educational campaign about covid and the vaccine so nursing home workers can make a personal choice based upon science, not misinformation shared on social media.
Those who have been following the coronavirus pandemic closely are likely not surprised that a concerning variant has emerged. This was one of the scenarios that worried infectious disease experts. Here is what caregivers should know about the delta variant:
What is different about the delta variant: It’s more transmissible, and is running rampant through America’s large swaths of unvaccinated populations. The debate is ongoing on whether it causes more severe disease. Hospitals across the US are seeing younger people fill up beds, which is different than earlier iterations of the pandemic.
How to protect elder loved ones: The good news is that roughly 80 percent of Americans over the age of 65 have been vaccinated, according to the CDC. If you have an elder in your life who has been reluctant to get vaccinated, now is the time for them to seriously reconsider. For those who cannot or will not get vaccinated, extreme caution when interacting with others, especially in public, is critical. That includes masking and limiting contact with unvaccinated people.
But what about the breakthrough cases in fully vaccinated people? Vaccines have never been full-proof. The influenza vaccine in particular is a roll of the dice each year when it comes to effectiveness. The COVID-19 vaccines face the same challenges, especially when it comes to variants. While the studies showing that vaccinated people can carry a similar viral load to the vaccinated, it’s important to focus on the bottom line. The overwhelming amount of people who are being hospitalized due to the delta variant are unvaccinated. The vaccinated breakthrough cases typically result in asymptomatic or mild symptoms. Down the road, booster vaccine shots may be necessary to address variants.
What about nursing homes? According to the government, 81 percent of nursing home residents and 58 percent of staff have been vaccinated. A concerning study found that aides working in nursing home have lower vaccination rates. These are the staff members who interact with residents the most, so for the well-being of residents and staff, more facilities may consider vaccine requirements. If you have concerns about unvaccinated staff members at a facility where your loved one resides, talk to management. It’s also possible that facilities will reimpose visitation restrictions to reduce the risk of outbreaks of the delta variant.
Will this ever end? I wish I had a crystal ball. Everyone is exhausted. It is particularly disheartening for those of us who followed the guidelines and got vaccinated, and now find that a variant is threatening to upend the cautious reopening phase. Some experts approach the future of coronavirus like seasonal influenza, where as a society we take precautions as we can, but accept that there will be cases, hospitalizations and even deaths in vulnerable populations. Former FDA commissioner Scott Gottlieb estimates that we are further along with the delta variant than we may think, and that while brutal, the variant will sweep through the country fairly quickly. Other variants may follow, so stay vigilant when caring for anyone who is older or in a vulnerable population. If it is safe for you and your loved ones to do so, try to stay engaged in activities that you enjoy, whether it’s being out in nature or in low-risk social situations. It’s important not to overlook our mental and emotional health while we address COVID-19 variants.