Before January 2017, there was no financial incentive for physicians to spend a little more time appropriately assessing an older adult experiencing cognitive loss. What the medical profession is now realizing is that persons living with an irreversible dementia (or other chronic illnesses) are depending, will depend, or has depended on someone to manage and coordinate their care as the condition progresses. From managing medical visits; medications; in-home care and social engagement; natural support systems are at the core of optimal care planning and are in desperate need of practical information and education about the dementia trajectory and what resources are available.
Physician practices are now faced with the responsibility of managing the care of persons living with dementia and their caregiver(s); in essence, at least two patients now exist. As it stands, general practitioners are not abreast of the many home and community-based services that now exist to aid in the person's ability to safely remain in their natural environment for as long as feasibly possible (i.e. in-home care aide, respite, environmental modification, etc) . Therefore, physician practices must make a conscious effort to seek out education on viable home and community-based options. A nursing home is not the only option and in some cases, it is not an option at all.
Persons living with a chronic illness must have comprehensive systems management for optimal care and this new Medicare benefit is a step in the right direction. Medical practices need social workers and community health workers now more than ever. In order to manage the amount of care and support that person living with dementia require, an ongoing dementia-specific care plan is needed with clinical and community professionals along natural support systems. Shared decision making is best remedy possible. When there is not a CURE, there is CARE.