The economics of Alzheimer's

[TexasHusker]

This isn't true at all in my experience, and being a doctor you might think I'd see it from your point of view.

I have lots of patients - definitely not the exceptions - who are 76 and beyond who are doing just fine. Sure they have their issues but you need to realize that the older you are, the less likely you are to have serious problems because if you had them, you would be dead already.

My oldest patient in my practice was 103 when she died. I can't say she was independent but she was still up and around and able to do a lot of things for herself. Another patient came to see me one time because she hurt her arm. She had fallen off the ladder while changing her curtains over from winter to spring. She was 94 at the time. She lived for several more years after that, just as independent as she was then. I had a patient who was diagnosed with bone metastasis from breast cancer - 20 years ago! She is now in her 80s and still 100% independent. My mother is 87 and completely independent. We kind of forced her to stop driving back in November. If not for us, she would still be doing that. My uncle passed away a few months ago. He was 93 and completely independent. In fact, just 2 days earlier he and his kids and grandkids had posted pictures on Facebook from their visit to the local aquarium. No cane. No walker. Just out and about at 93 years old just like you and me.

People aren't just living longer. They're living better. People are staying active and independent far longer than they used to. Primarily women but men too. I've seen men come in to the clinic who I actually questioned because I thought their date of birth was entered incorrectly. They were in their 80s and didn't look older than 60s. We were all shocked by their real ages.

good report!

[Thrif-t]

A good estate planner/attorney would likely be worth the investment of your time and money?

Yep I have a recommendation of one, its my New Years Resolution that I hope to get to this year. Had a few home repairs that had to be made, and I'd like to do some upgrading but I think I need to put them on the back burner and get this all handled. I'll do it though before years end.

[FLA]

In hospice, for me, Alzheimer's or dementia, was one fo the worst diagnoses with which I dealt. Unlike a rapidly spreading cancer, the caregiving needs are often spread out over ten years, not ten months. They are beyond exhausting for a family, most do not have long term care insurance and many are trying to keep the patient at home. The last two years they can get help from us as long as they are declining at a steady pace. But that help is intermittent and still leaves a heavy burden on the family. As the disaese worsens, caregivers are often on guard 24 hrs a day as the patient may have have the tendency to wander at night or have behavioral issues that prevent anyone from getting the rest they so desperately need. Caregiver burnout and fighting within families was the norm when I did hospice amongst people who could not afford to hire someone to come in for respite. One way of getting respite that isn't too costly is Adult Day Care.

the problem as I see it, is that Medicare does not pay for chronic care in the home or even a nursing home, for that matter, and Alzheimer's patients' care needs are usually chronic until close to the end of their disease trajectory. Medicaid does pay for chronic care in the home with programs like Nursing Homes without Walls, so the indigent elderly do get more help. It's really tough on the middle class. Assisted living uses up resources that you'd really need to get into a good nursing home which would use them to pay for care until the money runs out and then Medicaid takes over and the patient is still in a good nursing home. I've seen families blow their whole wad on assisted living and end up forced to use the county nursing home because there were no assets left. Alzheimer's is like a ten year prison sentence for the patient and the family that neither deserved, it's heartbreaking.

[LivingAlmostLarge]

My great grandmother lived independently till age 97. She never drove but walked. And my grandmother lived until 85. Even now she lives with my aunt but she goes to a day program and uses a cane at 90. Considering she got on a plane with my mom at 89 to visit me I'd say in good health. A lot of my grandmother's aunts (yes her aunts) lived independently until around 95. And her aunt just passed at 97 (the youngest). My grandfather's side the same thing. His oldest sister passed at 99 just a few months ago and multiple sisters alive.

My dad is 88 and we are traveling again with them this summer. He walks without a cane and looks surprisingly younger. He does get tired but manages well. He lives independently in many ways.

My aunt's MIL lives independently at 90 in her house alone. I can't tell you how many people I know do.