Expert: Michalene Peticca - 7/9/2007

Question
I would like to do a research paper with the scope of the paper on how the Medicare system will be affected by the upcoming Alzheimers crisis that is being predicted.  It has been determined that there are 65,000 cases of early on-set.  Can you give me any insight into this.  I am obtaining my masters in Health Care Management and would like to do my thesis paper on this.  My grandfather, whom I lived with for 10 years before he passed, died with alzheimers.  That is why I would like to focus on this.  Please help.  Thank you in advance for any help you can give me.  Also, what kinds of questions would I ask and to whom would I ask them to for a survey.

Answer
Hello Sherri,

Thank you for writing.  What a Great idea for a research paper!  I personally did mine...Over 15 years ago!...on a needed Reformation of our current Medicare system...so, you hit a spot on my soap box!

Actually, i believe you are going to find that our Medial Assistance system is the one that is going to be Most affected by the increased number of Alzheimer's individuals.  That is, Medicare is primarily for Hospital and Rehabilitation purposes only.   And, as you know, most Alzheimer's individuals are in very good health and have no rehab. potential....hence, Medicare doesn't have to worry much for their care.

Medical Assistance, on the other hand, is your "State welfare" for primarily senior citizens.  While there are some really wonderful families like yours out there to care for their relatives, there are a lot of folks that have little family involvement....for various reasons (geographic, financial, or just not wanting to deal with the disease).

Therefore, in long term care, we get the seniors that may have had Alzheimer's for 5 years+.......typical scenario how they get there:.......somehow end up in the hospital for a 3 day stay (Medicare Pushes to get them out fast to the nursing home)....they come to the nursing home for Rehab...they aren't able to do Rehab....Medicare cuts payments (you can ONLY have Medicare paying if you make progress...earlier said, they don't make progress)....and then families decide it is Much safer if they stay in the nursing home for the remainder of their lives.

Then, we sit down and discuss finances:  Some pay privately for awhile....and then go to Medical assistance.   Some go directly to Medical assistance.   Either way...because of the longevity of the disease (up to 20 years)...most Alzheimer's individuals have Medical assistance as their payor sources.  

So, what is happening now: 1.    Private Long term care facilities are limiting Alzheimer's folks from coming in (and a lot of facilities are getting rid of their "Alzheimer's units)    2.  Medical assistance applications is rapidly increasing     3. Families are looking at alternatives such as home care, personal care, etc. before nursing homes.

So...all that said....start at your Local Office of Aging and talk to a caseworker that deals with Medical assistance applications and ask them specifically about the number of application increases over the years for long term care.  Ask them the "average" Resource assessment amount (it's a field term..they'll know)...they are now seeing on those applications.   Ask them who is filling out those applications? (families, social workers, etc.)   Ask them how long an average, Alzheimer's or long term care individual stays on Medical assistance.

You may find statistics on your State website.  
Also, i would suggest going to the Johns Hopkins website and link into their Neurology dept. and check out Dr. Peter Rabins or Dr. Constantine Lyketsos for research information.  Johns Hopkins  also has an exclusive facility called "CopperRidge Institute" that they do much research at.  There is a website on that as well.   And, if you live close to Baltimore, MD....you may get a tour and interview with their staff i am sure!

Lastly, check out the www.medicare.gov website for any other info. you may need.

Hope this helps.  I know it is alittle different than what you want to write on...but, i think you will find it a Very deep subject!

Best of Luck and Sucess!!

Michalene Peticca, M.A.