Toll of Alzheimer’s disease, dementia growing in Sonoma County

Rising rates of Alzheimer’s disease and other forms of dementia are becoming a public health crisis that needs immediate attention and much more community and government planning, local health and social service officials warn.

More than 5 million Americans age 65 and older are living with Alzheimer’s, according to a new report by the Alzheimer’s Association, a Chicago nonprofit agency that supports research into the disease. That number is expected to triple to 13.8 million by 2050, its researchers projected.

In Sonoma County, more than one in 10 Sonoma residents over the age of 65 - or about 9,000 people - have Alzheimer’s or some other form of dementia, and their numbers are expected to grow rapidly over the next three decades as the baby-boom generation ages, the group projected.

“We have no strategic plan to address aging in the next few years, in spite of the wave of baby boomers becoming seniors,” Sonoma County Supervisor Shirlee Zane said.

The cost of caring for Americans with Alzheimer’s is expected to reach $236 billion this year and top $1.1 trillion by mid-century, according to the Alzheimer’s Association.

Most of the financial burden falls on the families and loved ones of those with dementia. Medicare, the primary health insurance program for Americans over the age of 65, covers only a portion of medication and limited home care after someone has been discharged from the hospital. Medicare also only pays for limited institutional rehabilitation, about 30 days, said Diane Kaljian, director of the adult and aging services division of the county Human Services Department.

“Most people with dementia are going to live 10 or 15 years, so they’re going to need a lot more financial support than Medicare alone,” Kaljian said.

The cost of caring for someone with Alzheimer’s can take a major financial and emotional toll on families, the association’s study found.

Nearly half cut back on their own expenses to pay for dementia-related care for a family member or friend. More than quarter ate less to save money for care, while one-fifth cut back on doctor’s visits. Half tapped into their savings or retirement funds and 11 percent reduced spending on their children’s education to help pay for the costs related to dementia. Thirteen percent sold personal belongings, such as a car, to help cover the costs of care.

More than a third of Alzheimer’s caregivers reduced their hours at work or quit their jobs to care for their loved one, the study found.

Many are under the false assumption that Medicare will pay for long-term care at a skilled nursing home or residential care home.

“If you have a dementia diagnosis, they will pay nothing,” said Helen Medsger, a Santa Rosa caregiver. “You are deemed, at that point, custodial care because this can go on for years and years. There’s nothing medically they can do to improve you, so Medicare does not pay.”

Medsger cares for her sister Maureen Shaw, who retired as executive director of Catholic Charities in 2007 after heading the nonprofit for 21 years. Shaw founded the organization’s Alzheimer’s Respite Program, which helps provide relief to local caregivers. It was her diagnosis with Lewy Body dementia, which has the same pathology as Parkinson’s disease, that precipitated her retirement.

Michele Osmon, program manager for the respite program, now renamed the Shaw Center for Memory Care, said she’s seeing people come into the program with an earlier diagnosis, at an earlier age, as well as a greater demand for services in general. Part of that is the result of stepped-up outreach by the program, she said.

With an average of 15 clients a day, the program is near its capacity of 18 daily clients, she said.

The program, which runs from 9 a.m. to 3 p.m. Monday through Friday, provides crucial socialization for dementia patients and includes arts, music and both memory and physical exercise activities. It also includes a nutrition program where patients are encouraged to eat well.

“They usually start with one day a week, but some clients come all five days,” Osmon said, adding that caregivers are given the opportunity to take care of their everyday needs, rest, go for a walk, do grocery shopping or simply have lunch with a friend.

Medsger said more supportive services are needed, though Sonoma County has more than many other counties. Aside from the local chapter of the Alzheimer’s Association and the Shaw Center, other programs in the county include the Redwood Caregiver Resource Center, which provides information, education and resources to families affected by dementia, and Kaiser Permanente’s Center for Memory Care, a vital resource for local Kaiser members with dementia and their families.

“We as a society need to understand dementia better so that possibly people can remain in their homes (and) so we can train families on how to care for their loved ones,” Medsger said.

Shelley Dombroski, regional director for the local Alzheimer’s Association, said North Bay residents affected by Alzheimer’s and other forms of dementia also benefit from being geographically close to three major diagnostic centers: the UC Davis Alzheimer’s Disease Center in the East Bay; the UCSF Memory and Aging Center; and California Pacific Medical Center’s Ray Dolby Brain Health Center.

Dombroski said diagnostic centers are the best places to get answers for a condition that can often be confusing for many families. Dementia, she said, is not a diagnosis but a group of symptoms caused by a specific disease or disorder.

Alzheimer’s, the most common form of dementia, comprises 70 percent of all dementia cases. Dementia cases caused by cardiovascular episodes are 17 percent of all cases. The symptoms of dementia can be reversible in 10 percent of the cases, Dombroski said.

“Some people suffering depression can show warning signs, but you treat the depression and those symptoms go away,” she said.

But the underlying factor for all dementia case is old age.

“The risk factor for Alzheimer is age,” she said. “There’s no cure, and with baby boomers aging in place, those numbers are just going to make it increase.”

Zane, who serves on the National Association of Counties, said there is no adequate federal legislative agenda focused on the social and economic repercussions of the nation’s growing senior population.

“Who are the primary people back in Congress? White men over the age of 60,” she said. “I think there’s a denial of aging in Congress. The denial is coming home to roost in every single household, with the care of aging parents and loved ones.”

Zane said a “national plan on aging” is needed, one that would bolster essential services that would help keep seniors healthy in their homes. That means keeping Social Security strong, supporting better nutrition through programs such as the local Meals on Wheels program operated by the Council on Aging, and beefing up case management services that go into homes where seniors live.

“The state has to step up, too,” she said. “It’s a cost to society, private health care and county services.”

You can reach Staff Writer Martin Espinoza at 521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @renofish.