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Legislative Viewpoint

Expanding services for dementia prevention and care

KulikState Representative Steve Kulik, First Franklin DistrictMemory loss and the inability to manage our own affairs is a frightening prospect, threatening, as it does, our independence and very sense of self. Therapists, clinicians, doctors and family members often feel adrift as they struggle to better respond to the needs of afflicted loved ones. Sadly, at this time, there are no known cures for dementia. Therapies can only slow its advance, and promising drugs have not lived up to expectations. But there is hope through greater understanding and support. Several of my colleagues in the Massachusetts Legislature are focused on regulations and laws to broaden eligibility for services, strengthen training for care providers, and allow spouses to serve as paid caregivers.

The state’s Executive Office of Elders Affairs, too, has embarked on a series of initiatives intended to promote better community understanding of Alzheimer’s and related diseases and ease the burdens on victims and their families. Regular readers of The Good Life may recall the recently published letter to LifePath from the Secretary of Elder Affairs, Alice Bonner, commending the agency for its efforts to “improve the lives of individuals living with dementia and their caregivers.”

Among the reforms being considered by the legislature is a bill filed by my House colleague Rep. Bruce Ayers of Quincy, that would extend the benefits of what is called the Frail Elder Home and Community-Based Services Waiver to people diagnosed with early-onset Alzheimer’s disease, regardless of their age. Currently, to receive a frail elder waiver you must be at least 60 and be financially qualified for MassHealth. Recipients of a waiver are eligible for a range of supports from adult day care and home and chore services to respite care for the primary or family care giver, with the goal of helping people stay in the familiar surroundings of their home rather than a nursing home. With the tragedy of dementia striking many younger people, Rep. Ayer’s bill is enlightened and timely.

Another bill of merit, sponsored by Rep. Jennifer Benson of Lunenburg, would, for the first time, make spouses eligible to serve as paid caregivers for dementia victims and others who struggle with daily living skills, and who are covered by MassHealth Standard. For some years, family members and friends (as well as outside individuals) have qualified for a stipend. It’s time to end the exclusion for spouses. Who else may be more available and knowledgeable of their partner’s needs?

A third bill, sponsored by Sen. Patricia Jehlen of Somerville, calls for the Office of Elder Affairs, through designated local agencies, to provide training to protective service caseworkers specifically focused on recognizing the signs and symptoms of Alzheimer’s disease to better understand how the illness may affect screening, investigation, and the provision of appropriate services.

Nationally, more than 30 percent of people over age 85 have some form of cognitive disorder. In Massachusetts, it’s estimated that more than 120,000 men and women are living with this impairment. Recent studies, including long-term research in Finland, have confirmed that individual lifestyle choices, including exercise, an active social life, cognitive stimulation, and a “Mediterranean diet” rich in fruits, vegetables, fish, and olive oil, can reduce the onset of dementia. Public policy, too, plays an important role. I am pleased that our Legislature is advocating for greater awareness and expanded services for prevention and care, which I fully support.