{"id":65480,"date":"2024-06-18T09:34:57","date_gmt":"2024-06-18T16:34:57","guid":{"rendered":"https:\/\/lapost.us\/?p=65480"},"modified":"2024-06-18T09:34:57","modified_gmt":"2024-06-18T16:34:57","slug":"barriers-to-alzheimers-care-for-rural-californians","status":"publish","type":"post","link":"https:\/\/lapost.us\/?p=65480","title":{"rendered":"Barriers to Alzheimer\u2019s Care for Rural Californians"},"content":{"rendered":"<div class=\"td_block_wrap tdb_single_author tdi_59 td-pb-border-top td_block_template_1 tdb-post-meta\" data-td-block-uid=\"tdi_59\">\n<div class=\"tdb-block-inner td-fix-index\">\n<div class=\"tdb-author-name-wrap\"><span class=\"tdb-author-by\">By<\/span><a class=\"tdb-author-name\" href=\"https:\/\/ethnicmediaservices.org\/author\/selen-ozturk\/\">Selen Ozturk<\/a><\/div>\n<\/div>\n<\/div>\n<div class=\"td_block_wrap tdb_single_date tdi_60 td-pb-border-top td_block_template_1 tdb-post-meta\" data-td-block-uid=\"tdi_60\">\n<div class=\"tdb-block-inner td-fix-index\"><i class=\"tdb-date-icon tdc-font-fa tdc-font-fa-calendar\"><\/i><time class=\"entry-date updated td-module-date\" datetime=\"2024-06-17T12:25:48-07:00\">Jun 17, 2024<\/time><\/div>\n<\/div>\n<div class=\"td_block_wrap tdb_single_subtitle tdi_61 td-pb-border-top td_block_template_1\" data-td-block-uid=\"tdi_61\">\n<div class=\"tdb-block-inner td-fix-index\">\n<p>With Alzheimer\u2019s now the second-leading cause of death for people in California, barriers to treatment are more harmful than ever.<\/p>\n<\/div>\n<\/div>\n<div class=\"td_block_wrap tdb_single_featured_image tdi_62 tdb-content-horiz-left td-pb-border-top td_block_template_1\" data-td-block-uid=\"tdi_62\">\n<div class=\"tdb-block-inner td-fix-index\"><img loading=\"lazy\" decoding=\"async\" class=\"entry-thumb td-animation-stack-type0-2\" title=\"caregiver\" src=\"https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2024\/06\/caregiver.jpg\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" srcset=\"https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2024\/06\/caregiver.jpg 1200w, https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2024\/06\/caregiver-300x200.jpg 300w, https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2024\/06\/caregiver-1024x683.jpg 1024w, https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2024\/06\/caregiver-768x512.jpg 768w, https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2024\/06\/caregiver-150x100.jpg 150w, https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2024\/06\/caregiver-696x464.jpg 696w, https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2024\/06\/caregiver-1068x712.jpg 1068w\" alt=\"\" width=\"1200\" height=\"800\" \/><\/div>\n<\/div>\n<div class=\"td_block_wrap tdb_single_content tdi_63 td-pb-border-top td_block_template_1 td-post-content tagdiv-type\" data-td-block-uid=\"tdi_63\">\n<div class=\"tdb-block-inner td-fix-index\">\n<p>Although the number of Californians living with Alzheimer\u2019s will nearly double to 1.1 million within twenty years, those in rural and remote areas face major challenges to accessing care.<\/p>\n<p>Compared to urban communities, these rural Californians struggle to access preventative services, including screenings, diagnostic care, clinical visits, and appointments with specialists. Long wait times and a lack of public transportation are also common issues.<\/p>\n<h2 class=\"wp-block-heading\">Alzheimer\u2019s access in remote California<\/h2>\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<div class=\"td-video-replacer\" data-id=\"undefined\"><\/div>\n<div class=\"wp-block-embed__wrapper\"><iframe loading=\"lazy\" id=\"widget2\" title=\"The Social and Economic Drivers of Alzheimer\u2019s Rates in Disadvantaged Communities\" src=\"https:\/\/www.youtube.com\/embed\/eaDW6BkqQuc?feature=oembed\" width=\"100%\" height=\"392\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\" data-mce-fragment=\"1\"><\/iframe><\/div><figcaption class=\"wp-element-caption\"><em>Dr. Rita Nguyen, Assistant Health Officer for the State of California and Director of Population Health, California Department of Public Health, discusses the barriers to health faced by disadvantaged ethnic and geographic communities and the role of public health in removing those barriers.<\/em><\/figcaption><\/figure>\n<p>With Alzheimer\u2019s now the second-leading cause of death for people in California\u2014home to more adults aged 65 and over than any other state\u2014barriers to treatment are more harmful than ever, said Dr. Rita Nguyen, assistant health officer for the state of California and population health director for the California Department of Public Health (CDPH).<\/p>\n<p>There were 660,000 Californians living with Alzheimer\u2019s in 2019; that number is expected to more than double to nearly 1.5 million in 2040.<\/p>\n<p>While rural California is home to just 6%\u20142.3 million residents\u2014of the state\u2019s overall population, residents in these areas are also older than their urban counterparts; more geographically isolated from clinics, caregivers and specialists; and more prone to Alzheimer\u2019s risk factors like heart disease, hypertension and diabetes.<\/p>\n<p>\u201cThe Surgeon General has\u00a0<a href=\"https:\/\/www.hhs.gov\/about\/news\/2023\/05\/03\/new-surgeon-general-advisory-raises-alarm-about-devastating-impact-epidemic-loneliness-isolation-united-states.html\">highlighted<\/a>\u00a0the immense impact that loneliness has on health outcomes,\u201d noted Nguyen, adding that stigma around Alzheimer\u2019s adds to the isolation many experience, despite the fact that most Californians are \u201cconnected by one or two degrees\u201d to someone with the disease.<\/p>\n<p>In response, CDPH has launched\u00a0<a href=\"https:\/\/www.takeonalz.com\/\">Take on Alzheimer\u2019s<\/a>, the first-ever statewide campaign to reduce stigma around the disease and teach Californians how to detect it and what to do after a diagnosis.<\/p>\n<p>\u201cOur own research on access barriers to Medicaid, the largest payer of long-term U.S. care access, has involved over 40 focus groups and over 100 individual interviews,\u201d said Hagar Dickman, senior attorney at Justice in Aging. \u201cWe found, statewide, that low-income individuals with mid-to-late Alzheimer\u2019s and dementia, particularly in rural areas, generally have no options to access community or personal care programs.\u201d<\/p>\n<p>For instance, California\u2019s largest program for low-income adult home care\u2014In-Home Support Services, serving 700,000 individuals\u2014\u201cis essential for keeping adults in the community and out of nursing homes, but it\u2019s self-directed. Users apply for, find, hire, supervise and fire their caregivers, and 70% of users have a family caregiver,\u201d she explained. \u201cBut it doesn\u2019t work for those who can\u2019t direct their own care,\u201d she added, suggesting an agency option, and integration of caregiving with social services like housing.<\/p>\n<p>Other Medicaid programs like\u00a0<a href=\"https:\/\/www.dhcs.ca.gov\/services\/ltc\/Pages\/AssistedLivingWaiver.aspx\">Assisted Living Waivers<\/a>, available in only 15 of California\u2019s 58 counties, can have 3,000-person waitlists. (Medi-Cal is California\u2019s version of the federal Medicaid program.) Community-Based Adult Services, an adult day health program available in about 22 counties, closed many centers during the pandemic in rural counties which already have less alternatives like nursing homes, caregivers and specialty clinics.<\/p>\n<p>\u201cWe found that those with neglected needs go into institutional care or die at home as providers \u2026 social workers and community organizations struggle to find support for those who come to them for help,\u201d Dickman said. \u201cOnce the Alzheimer\u2019s is mid-to-late, often in despair, they call Adult Protective Services, even though it can\u2019t really assist.\u201d<\/p>\n<p>\u201cWhat became clear from talking to rural participants is that many policy solutions that may work in urban areas really are not appropriate for rural areas, because of low density, lack of providers and lack of infrastructure,\u201d she continued. \u201cAny solution, to help individuals with Alzheimer\u2019s who don\u2019t have family caregivers, needs to address these issues.\u201d<\/p>\n<h2 class=\"wp-block-heading\">Alzheimer\u2019s outreach in rural SoCal<\/h2>\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<div class=\"td-video-replacer\" data-id=\"undefined\"><\/div>\n<div class=\"wp-block-embed__wrapper\"><iframe loading=\"lazy\" id=\"widget4\" title=\"In Rural California, Dementia Care Services Are Limited and Difficult to Access\" src=\"https:\/\/www.youtube.com\/embed\/MT1UnXYlvWg?feature=oembed\" width=\"100%\" height=\"392\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\" data-mce-fragment=\"1\"><\/iframe><\/div><figcaption class=\"wp-element-caption\"><em>Hagar Dickman, Senior Attorney, Justice in Aging, shares data from a research project on the accessibility of Alzheimer\u2019s care in rural California.<\/em><\/figcaption><\/figure>\n<p>\u201cOur population is growing. In the Inland Empire alone, there\u2019s a projected 685% increase in people 65 and over by 2060,\u201d said Carmen Estrada, executive director of the Inland Caregiver Resource Center, a network of 11 free caregiver service centers in the San Bernardino, Riverside, Inyo and Monroe counties of Southern California. \u201cOur infrastructure is definitely not ready for that, but we\u2019re hopeful we can implement what we found about reaching people.\u201d<\/p>\n<p>\u201cFirst of all, we use word of mouth,\u201d she continued. \u201cIt\u2019s not just about dropping off brochures at a community center or church \u2026 individuals in rural communities are close-knit, and to foster trust we encourage current clients to tell others about how we can help them care for loved ones with Alzheimer\u2019s\u201d through services like counseling, caregiver referrals, caregiving training and respite care.<\/p>\n<p>\u201cMost importantly, we learn what the community needs,\u201d Estrada continued, through listening sessions and focus groups, as well as what the best channels are for delivering information, whether it\u2019s \u201cflyers, TV, radio?\u201d Language accessibility is also critical.<\/p>\n<h2 class=\"wp-block-heading\">One caregiver\u2019s story<\/h2>\n<p>\u201cI\u2019ve been caring for my brother three years since he got diagnosed with frontal temporal dementia, and it\u2019s been challenging,\u201d said Maria Cortez, a Glenn County-based 66-year-old caregiver for Jerry, her 62 year old brother with Alzheimer\u2019s.<\/p>\n<p>She lived in Texas when he first showed abnormal symptoms, including losing his job, drinking frequently, being verbally abusive to siblings who\u2019d visit him and blacking out while driving, totaling his car on one occasion.<\/p>\n<p>\u201cHe was then living alone in our parents\u2019 home and had four friends who saw what was going on, moved in, and took over the home and his bank account,\u201d Cortez said. \u201cThey had him living worse than a dog, so I took him to Texas. He was upset, so after a few months we went back to remove his friends. It took three to four months to evict one \u2026 If we hadn\u2019t intervened, my brother would be dead by now.\u201d<\/p>\n<p>\u201cSince he had no money left, I spent a month and a half struggling with paperwork to get him on Medi-Cal,\u201d she explained. Unable to get a neurologist in Chico, 10 minutes away, \u201che got one in Sacramento, early appointments two hours each way.\u201d<\/p>\n<p>\u201cThe symptoms progressed so fast, about every two months,\u201d said Cortez. \u201cIt was memory loss, then anxiety, hallucinations, depression, losing empathy, personal hygiene and the ability to feed or dress himself. In the last month or two he can no longer bathe himself, which has been difficult for me, being his sister.\u201d<\/p>\n<p>She added that her brother has been able to join the Peg Taylor Center for Adult Day Health Care in nearby Chico, where he goes two to three times a week for up to four hours per visit, \u201cThey\u2019re wonderful,\u201d she said. \u201cHe\u2019s now like a three year old in an adult body, and this is the only program I know of here that gives me time to catch up, go out, do what I want for a bit.\u201d<\/p>\n<p>Cortez said the most fulfilling part of caring for her brother despite these challenges \u201cis that I helped him be alive, for however many years he\u2019s got left. But we didn\u2019t know what was happening for a few years, and that could have helped him \u2026 If you\u2019re facing similar issues, learn the signs.\u201d<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>BySelen Ozturk Jun 17, 2024 With&#46;&#46;&#46;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6,16],"tags":[],"class_list":["post-65480","post","type-post","status-publish","format-standard","hentry","category-ca-local","category-health"],"_links":{"self":[{"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts\/65480","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=65480"}],"version-history":[{"count":1,"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts\/65480\/revisions"}],"predecessor-version":[{"id":65481,"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts\/65480\/revisions\/65481"}],"wp:attachment":[{"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=65480"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=65480"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=65480"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}