Often, even though a physician or another health care provider has identified cognitive impairment, the patient and his or her family and caregivers are not told of the diagnosis. Further, once a diagnosis is made and disclosed, as few as half of patients and families receive counseling, support, or information about next steps. This information is important, especially for early-stage individuals who experience positive outcomes when they are involved in planning and receive appropriate services. The actions below will address this gap by educating physicians and other health care providers, incentivizing discussions with people with AD/ADRD and their families, and enhancing the ability of other networks to assist people living with AD/ADRD and their families with addressing their needs.
(UPDATED) Action 2.C.1: Educate physicians and other health care providers about accessing long-term services and supports
One barrier to counseling and support is that health care providers are not aware of available services or how to access them. To increase knowledge of these resources among physicians, nurses, and hospitals, HRSA is working with federal partners, public and private entities, the health care provider community, and community organizations that provide LTSS to effectively educate physicians and other health care providers, direct services workers, and patients, families, and caregivers about support resources and services available to assist people with AD/ADRD, as well as their caregivers. These activities will continue as part of the training in Action 2.A.1.
In addition, since 2017, CMS has made separate Medicare payment for cognitive assessment and care planning services for individuals with cognitive impairment. A required element of these services is the creation of a care plan, including referral to community resources as needed (e.g., rehabilitation services, adult day programs, support groups), and a requirement that the care plan is shared with the patient and/or caregiver with initial education and support.
(UPDATED) Action 2.C.2: Connect American Indian and Alaska Natives to Alzheimer's disease and related dementias resources
The focus on increasing support to caregivers has been through the spread of REACH into Indian Country, with the goal of offering this intervention to those with AD/ADRD and their families. IHS has begun a collaboration with the CDC in the development of the Brain Health Public Health Road Map designed specifically for Tribal Communities.
Tribal communities continue to benefit from ACL's state and community AD/ADRD grant programs, including development of culturally-competent dementia care specialists, dementia-friendly community education/awareness initiatives and translation of the Music and Memory intervention in Indian Country.