News

Jul 07, 2023

Lack of training on dementia care a key concern

When Janice Guzman’s elderly mother was diagnosed with Alzheimer’s several years ago, she put aside her dream of pursuing a career in criminal justice to become a personal caregiver. While she lacked

When Janice Guzman’s elderly mother was diagnosed with Alzheimer’s several years ago, she put aside her dream of pursuing a career in criminal justice to become a personal caregiver.

While she lacked knowledge of dementia care, Guzman benefited from a Medicaid-funded program in Massachusetts that provides training for dealing with Alzheimer’s and other memory loss illnesses, and pays her an hourly stipend to work as a caregiver living with her 83-year-old mother.

But Guzman says there isn’t enough training and support for personal care workers, who provide care for an estimated 80% of the nation’s Alzheimer’s patients.

“Most people don’t know how to work with people who have dementia and memory loss,” she said. “Families that need support just aren’t getting it. It’s a difficult situation.”

Massachusetts was one of the first states to mandate training for dementia care. In 2018, the state approved a law requiring physicians, assistants and registered nurses who treat adults to attend a one-time training event in diagnosing Alzheimer’s disease for treating and caring for people with dementia.

It’s also among a dozen or so states that pay any relatives, including spouses, parents of minor children and other legally responsible relatives, to provide home care. There are currently about 60,000 personal care workers in the state.

But even in a state that was ahead of the game in pushing for formal training, support for personal care workers remains limited, Guzman said. Many face struggles finding primary care physicians and other professionals to provide medical care for their clients, which many cases are their own relatives, she said.

The situation is much the same in other states, with recent studies showing the nation’s health care workforce lacks effective dementia training and resources.

There were 290,000 licensed nurse practitioners in the U.S. in 2020, but fewer than 13% had expertise in geriatric care, and even fewer focused on dementia, according to a recent study by the Alzheimer’s Association and the Centers for Disease Control and Prevention.

Less than 1% of registered nurses, physician assistants and pharmacists identify themselves as geriatric specialists, according to the study, while fewer than 5% of geriatric social workers have specialized geriatric training.

A 2020 report by the American Public Health Association found that public health and long-term care systems often do not effectively support people with dementia, and that the long-term care workforce “lacks effective dementia training and resources.”

“Gaps in the availability of adequately trained health care and direct care professionals with geriatric and dementia-specific training indicate a market failure,” the report’s authors wrote.

The report said public health policies for hiring, training and retention of the dementia care workforce “must be strengthened to expand the supply of health and social care professionals, including direct care workers,” with the necessary skill sets to effectively work with an aging population.

The Alzheimer’s Association has created a training and certification program to educate workers and clinicians about the diseases. It focuses on person-centered care, assessment and care planning, activities of daily living, and communication changes and dementia-related behavior.

Doug Pace, the association’s senior director of long-term and community-based care, said caring for someone with dementia is complicated, and making sure that people have the training is very important.

“It’s not only about recruitment and retention,” he said. “It’s about making sure that once you hire someone, you are providing them with all the tools and resources and training.”

A series addressing a myriad of issues facing those struggling with dementia, either as patients or caregivers.

Monthly bills came due; taxes, too. Frank Duffy had the money to pay. What he was losing was the capability.