Executive Summary

“Alzheimer’s disease and related dementias are irreversible, progressive brain diseases that affect millions of Americans.”

These feared diseases slowly destroy brain function, leading to cognitive decline, behavioral disorders and decreased functional abilities. Of the most frequent causes of death in the nation, dementia related diseases are the only ones that cannot be prevented, cured, or effectively treated. Dementia places substantial emotional, physical, and financial stress on affected individuals and their family members.

Dementia research is gradually gaining support, yet progress towards finding curative or therapeutic treatments has been slow. Researchers still do not understand the disease on a molecular level, making development of effective treatment options difficult. Further and substantial research is needed to better understand disease prediction and progression while developing novel care delivery interventions to improve health outcomes.

The slow pace of innovation, along with the substantial costs associated with dementia, has created momentum around the world to develop strategic plans. The United States has adopted a goal to prevent and treat Alzheimer’s disease and related dementias by 2025, a goal shared as well by Canada, France, Germany, Italy, Japan, and the United Kingdom. Multi-government agencies have committed to improving dementia care including the World Health Organization and the United Nations.

Private organizations are also dedicating resources including The Global CEO Initiative on Alzheimer’s Disease, a group of Fortune 500 companies committed to accelerating dementia research. Alzheimer’s stakeholders around the globe are searching for new data, new insights, and new tools to prevent and treat the disease.

Similar to many places around the world, Montana faces significant public health and financial crises due to the projected prevalence of dementia in the near future. Because Alzheimer’s disease and related dementias predominately affect the elderly, staggering increases in the prevalence of dementia are expected as the baby boomer generation ages. This will result in an enormous impact on families, caregivers, and health and social service providers, and will cause substantial increases in health care costs.

Anecdotal evidence from Town Hall meetings held across Montana reveal the current health care system for persons affected with Alzheimer’s disease and related dementias lacks coordination, does not meet the needs and desires of Montanans, and is financially unsustainable. The state lacks sufficiently trained and knowledgeable health care workers, availability of support services for families and caregivers, and appropriate and affordable long-term care options.

The Montana’s Alzheimer’s and Dementia State Plan—Addressing the Current and Future Needs of Individuals and families with Alzheimer’s Disease and Related Dementias was developed by the Montana Alzheimer’s Disease/Dementia Work Group—a voluntary group of health care professionals, advocacy groups, stakeholders, caregivers, educators, and citizens who have been affected by dementia and are passionate about improving dementia care in Montana.

The Work Group recognized the existing inadequacies and concluded that Montana must be proactive in addressing the impending crisis dementia poses. Based on extensive research and data collection, Town Hall discussions with hundreds of Montanans including Native American populations, and examination of approaches taken in other states, the Work Group developed goals and action steps to address the numerous issues surrounding Alzheimer’s disease and related dementias throughout the state.

The Montana Alzheimer’s and Dementia State Plan prioritizes 11 major goals that envision the creation of a health care system in each community able to manage the needs of individuals living with Alzheimer’s disease and related dementias and their families throughout all stages of the disease. These goals rest on the assumption that all persons should be able to experience the highest quality of life while maintaining independence and choice regardless of socio-economic status, rural or urban residence, income, race, religion, or sexual orientation.

Each goal area includes recommended action steps crucial to reaching these goals. These action steps range from significant policy changes to improved education and awareness to development of practical resources for individuals living with dementia and for their families. Some of these steps will require financial resources; all will require commitment, cooperation and courage.

The 11 Major Goals of the MT Alzheimer’s & Dementia State Plan are to:

  1. Promote public awareness and understanding about Alzheimer’s and related dementia diseases.
  2. Encourage all health care providers to recognize and diagnosis dementia early in the process and appropriately refer individuals and families to community resources.
  3. Ensure that Montanans with dementia and their caregivers are aware of, and have access to, Montana-specific materials regarding legal and financial planning.
  4. Promote person-centered care, ensuring that Montanans with dementia are able to age in place in the least-restrictive setting while maintaining a high quality of life.
  5. Maintain adequate numbers of health care workers who are trained to meet the needs of the population experiencing Alzheimer’s disease and related dementias.
  6. Promote dementia-friendly communities in Montana where individuals and their caregivers are treated respectfully and have opportunities to actively participate in community life.
  7. Improve dementia data collection and research efforts in Montana. Reduce caregiver burden and stress by promoting systemic changes in medical and social systems, and employment practices that will support and empower caregivers.
  8. Expand the availability of high-quality, affordable home and community-based services that meet the needs of individuals living with dementia, allowing them to live in the most appropriate and least-restrictive setting.
  9. Promote wellness and maintenance of cognitive function at residential care facilities through activities tailored to each individual, and employ staff trained in person-centered interventions and models of care.
  10. Provide high quality palliative and hospice care for individuals with dementia during the end of life and support for their families and loved ones.
  11. To implement and achieve these goals, the Montana Alzheimer’s/Dementia Work Group has sought a diversified path of funding sources. From partnerships in the private sector to associations with state agencies, the Work Group has and will continue to promote and pursue grant opportunities, funding initiatives, and legislative proposals to implement the vision of improved dementia care in Montana.

Dementia is an illness with a fatal outcome that is plaguing families with emotional and financial burdens.

Dementia will affect each of us, either personally or through a family member or friend. Citizens across the state are rightly asking for a higher degree of preparedness and responsiveness.

We must be prepared for the growing number of Montanans who will be affected by dementia. Solutions are not simple, yet by working together, Montanans can advance strategies that will result in positive and meaningful impacts for individuals and families living with Alzheimer’s disease and related dementias.

The state plan is also a Call to Action for individuals, caregivers, and organizations who are affected by dementia and concerned with improving dementia care in Montana communities.

Although there have been recent public policy victories at the national level over the past decade, dementia remains one of the most critical, unaddressed public health concerns in the United States, making the disease an urgent public health crisis.

Alzheimer’s disease demands a bold, collective and rapid response—the time is now to change the course of this devastating disease.