Cognitive Impairment Screening in Senior Citizens

I told you three times yesterday you had a doctor's appointment and that I was going to come pick you up. † Judy shuffled back to the kitchen to double check her calendar, followed by her daughter. Both of them stopped in their tracks, taking in the ransacked kitchen. Her daughter asked what had happened in here, but Judy couldn't answer her. She was beside herself. Who could have possibly broken into her home and torn her kitchen apart? Dementia has reared its ugly head. Phil Just wanted to pay for his Reuben. He had been out and about running errands and was very hungry.The young man behind the counter had tried to charge his debit card more than a few times, but to no avail the card was denied each time. Phil began to recant his day to himself. Then It dawned on him, he had closed his bank account only a few hours before. Phil was getting ready to move down to Texas with his son due to his recent diagnosis of Alchemist's. Phil was a regular at the dell and the manager gave h im the Reuben on the house. â€Å"One of the worse things about this rotten disease Is losing the ability of taking care of myself† (Phil Rolled, 2010). Just frustrating for me, not to remember what I need to do to Just feel like I still can live and take care of myself. † This Is a common frustration expressed by those suffering diseases like dementia and Dementia is a costly disease; for the five million people like Phil and Judy living tit the disease in the United States, for Phil and Judy family, and for the government. Earlier detection and intervention of dementia would provide Phil and Judy the time to plan for the future and get the utmost benefit from available treatments.Earlier detection and intervention of the disease would lessen the future financial burden on health care. Cognitive impairment screening would ascertain if early intervention is needed. Cognitive impairment screening in senior citizens must become practice. Dementia is used as an umbrella te rm; describing a wide range of symptoms that include a progressive decline in mental ability severe enough to interfere with daily life. Dementia slowly robs Phil and Judy of their memories. At first, they experience problems with their short-term memory such as remembering an appointment.As time passes, the disease steals more and more of the brain. Phil and Judy eventually will not be able to respond to their environment, nor will they be able to express when they are in pain, or hungry, or thirsty, or when they have to go to the bathroom. A true diagnosis is rare, because dementia affects everyone differently. There is no ere. Dementia is considered an old person's disease. It's normal to forget where you left your keys when you're 65 years old or to forget where you parked the car. Contrary to popular belief, dementia is not a normal part of aging.Alchemist's is the most common type of dementia, but there are many other types. One of the biggest risk factors in developing dement ia is a person's age. Unless someone has stumbled onto the fountain of youth, no one can change or hide from their age. Persons age 65 and older have a greater risk of suffering from dementia. Every five years those Hansen double, so by the time Judy is 85 years old – her chance is nearly 50 percent. Today, there is an estimated five million people living with a dementia related disease in the United States. (What is Dementia, n. D. With the first wave of Baby Boomers already at age 68, the cost of dementia in 40 years is expected to exceed $1. 2 trillion (Alchemist's Fact and Figures, n. D. ). In 2010, the worldwide costs associated with dementia equaled one percent of global GAP. One percent doesn't seem like much on a global scale. However, if dementia care was a company; Dementia Inc. Loud be considered the world's largest by annual revenue. (GE Healthcare, 2014) The Alchemist's Association predicts the total number of dementia-related cases in the United States will reac h 14 million in the year 2050.Our healthcare system and the Medicare program are already strained. As the Baby Boomers get older, are we going to be able to weather the suffocating financial squeeze this disease is going to create? Phial's family is lucky to catch the disease before it has progressed too far, his son will be able to take care of him at home until the disease progresses further. The average cost for caring for someone at home is $12,500 per year. As the disease robs Phil of more brain function, more skilled care is required. Families can be billed anywhere from $42,000 to $72,000 per year.Victims and their families can easily deplete their savings on medical care and then turn to Medicare/Medicaid and tax payers to help with the remaining costs. Judy may have already passed the opportune time to either stay at home with her daughter or have in-home care and ultimately needs to go live either in an assisted living or nursing themselves for the price of skilled care. S enator Tom Harkin stated â€Å"The only way we are truly going to save Medicare from bankruptcy when the baby boomers retire is to reduce the length and incidence of expensive illnesses like Alchemist's. Harkin, Chairman of the Appropriations Subcommittee on Labor, Health and Human Services, and Education, and Related Agencies recently held a hearing in February of 2014 to inspect the financial impact of Alchemist's in America (Bethlehem, 1998). But how do we reduce the length of disease that has a difficult diagnosis and no cure in the foreseeable future? We need to be looking at intervention opportunities. All things considered, some will argue that dementia-related diseases are only a small part of a much bigger problem, dismissing the idea that the disease could bankrupt Medicare. Projections of the frequency of a disease 30 years from now should be taken with a grain of salt,† said Gail Wiliness, chairman of the federal Physician Payment Review Commission (Bethlehem, 199 8). â€Å"We don't know how the frequency of other disease will rise or fall, and how that will affect longevity. † She went on to commend the fact that medical research has allowed people to live longer lives and improve quality of fife. However, she questioned whether the research has saved us any money.Wiliness almost sounds like she is agreeing with another rarely expressed view that concludes if we devote more money and effort into finding a cure for dementia; that will only prolong the life of the elderly by a few more years. Crudely put, if you don't die of complications from dementia, you'll still die of something else. Understandably, we can't avoid death. That is an inevitable fact of life. If we as a community could act early, if we as a community could provide intervention, what kind of standard would e set for the rest of the nation?Earlier detection of dementia could provide earlier intervention, delay the impact of the disease, and prevent significant health ev ents in the future. Does that process sound familiar? In 2013, The United States Preventive Services Task Force recommends women get a mammogram every 2 years starting at age 50 to keep proactive about breast cancer (Mammograms Fact Sheet). Furthermore, the same task force recommends oscilloscopes in adults beginning at age 50 and continuing until age 75 (at different intervals depending on family history) o prevent colon cancer.Curious, I went to the U. S. Preventive Services Task Force website on Recommendations for Adults. I found preventative information on 19 different cancers and 11 different types of heart disease. I found nothing on dementia or Alchemist's. Nothing. Alchemist's disease is the 6th leading cause of death in the United States (Leading Causes of Death, 2011). The top five include heart disease, cancer, chronic lower respiratory disease, and stroke. All five of those diseases all have preventative measures and are routinely screened for in our annual heck-ups wit h our doctors.What needs to be addressed though is why there is more prevalence on detecting cancers and heart disease? John Morris, professor of neurology and co-director of the Alchemist's disease research center at Washington University's School of Medicine, believes we should find a way to distinguish between the normal aging process and early dementia and build more interest (Bethlehem, 1998). This is where a cognitive assessment could help bridge that gap. A cognitive assessment is an examination that is used to determine someone's level of cognitive function.A group of 2,719 elderly residents in Almagest County, Minnesota were 2014). The doctors conducting the case knew from earlier studies that elderly residents would sometimes have a cognitive assessment that indicated some impairment, but when examined again later, the impairment had lessened or completely gone away. During this trial, 40% of people with a mild cognitive impairment reverted back to a more normal state. At the end of the study, the doctors found that 65% of those â€Å"reverts† went on to develop dementia (Berliner, 2014).While this study shows that not everyone who has cognitive impairments may o on to develop dementia, the doctors were certainly more aware of any changes. Unfortunately, there isn't one type of assessment test that is better than the others. However, the Alchemist's Association website has recommended several cognitive assessment tools that can be performed in less that or around five minutes in a primary care or community setting. Not only are there patient assessment tools, there are informant tools for family members and close friends to use as well. Utilizing these assessments Just once isn't going to do the trick.Then again, imagine f the U. S. Preventative Services Task Force recommended a cognitive assessment screening every two-three years starting at age 65. Cognitive impairment screening must become practice for senior citizens. The assessments may n ot garner conclusive data, but over time we will be able to create a clearer picture as to how dementia slowly progresses. From that picture, we will develop earlier intervention techniques to help ease not only the financial strain on Phil and Judy and their families, but ease the frustration felt by dementia's victims.