Family Caregivers as Members of the Alzheimer’s Treatment Team

Abstract

Alzheimer's is a common disease with predictable neuropathology changes and characteristic functional declines. Family members of people with Alzheimer's disease most frequently generate the impetus for workup and diagnosis, since it is a hallmark feature of the disease that patients lack the ability to recognize their own functional decline. Following initial diagnosis, family caregivers find themselves directing a series of multiplying and complex interactions with the health care system on behalf of their afflicted relations as the disease pursues its course through complications to the finality of death. Alzheimer's disease patients are hospitalized more frequently and, when hospitalized, experience significantly longer lengths of stay than matched controls. Sixty-three (63) percent of Medicare expenditures for patients with Alzheimer's disease are for in-patient hospital care. More than 60% of residents in skilled nursing facilities suffer from dementia. This cognitive dysfunction (not always but primarily Alzheimer's disease) is usually the major reason for institutional care. The role of the family caregiver in this progression is pivotal, the responsibility enormous. This chapter will consider the pivotal role of the family caregiver, the shortcomings inherent in current modes of practice and reimbursement, as well as the direction of promising new approaches, and the need for ongoing research to firmly establish a justification for a major paradigmatic shift. (PsycInfo Database Record (c) 2021 APA, all rights reserved)