MDNews - Mid Hudson

A GING IN PLACE is the goal for 90 percent of seniors, according to an AARP study. However, a variety of obstacles can make this vision a challenge. Patients who have dementia, in particular, cannot live alone in the home, and most often, assistance comes from unpaid, nonprofessional fam- ily members — sometimes supplemented by paid home health workers. It is a taxing job, notes Gary Epstein- Lubow, MD, a psychiatrist who teaches at The Warren Alpert Medical School of Brown University. "Treatment for the patient with demen- tia is just one facet of good care," he writes in Health Affairs, a health policy journal. "Dementia also takes a toll on the family caregivers — a toll that cannot be discounted." Helping Families in the Home North Dakota's Dementia Care Services Program (DCSP), with assistance from By Jennifer Webster IN NORTH DAKOTA, A PROGRAM TO ENABLE DEMENTIA PATIENTS TO LONGER IS REDUCING THE STRAIN ON FAMILIES, PHYSICIANS, EMERGENCY HEALTHCARE FACILITIES. the University of North Dakota's (UND's) Center for Rural Health and School of Medicine and Health Sciences, served almost 1,000 people with dementia during its fi rst three years in operation. The program's twin goals are to empower caregivers and enable patients to continue living at home. By those measures, it experienced robust success. Families dementia even Wagstrom A sso Faculty and Klug, Center 911 relatives caregivers' The via Fa Alzheimer's and They legal "Many in person one second wait Physicians, able with assistance as hospita patients savings ing at $39.2 program Home confi professionals," them cess you better A Co$t-effective Approach to Helping Patients with Dementia GROWTH INDUSTRY Sales of home health devices such as medication apps, motion sensor- enabled monitors and telemedicine platforms are expected to double by 2018, according to IHS Technology. CORE 8 COVER FEATURE PREDICTIVE TEST FOR ALZHEIMER'S RAISES MEDICAL POSSIBILITIES, ETHICAL QUESTIONS 6 A blood test could provide up to three years of presymptomatic notice that a person is likely to develop Alzheimer's disease. That presents therapeutic opportunities — and a host of difficult issues concerning how patients may respond to that knowledge. A COST-EFFECTIVE APPROACH TO HELPING PATIENTS WITH DEMENTIA LIVE AT HOME 8 North Dakota has eased the burden on families, physicians and healthcare facilities by implementing a program that makes it possible for people with dementia to remain in their homes longer. FEATURE A NATION IN WAITING (ROOMS) 10 Some observers believe healthcare reform will increase wait times at doctors' offices. In anticipation of that possibility, physicians can employ strategies to make the time patients spend waiting more productive — and less likely to negatively affect revenue and the patient experience. Contents | SEPTEMBER 2014 | DEPARTMENTS PEOPLE IN THE NEWS 5 CME CREDITS 12 LOCAL NEWS 14 Predictive Test for Alzheimer's Raises Medical Possibilities, Ethical Questions PAGE ON THE COVER

• Cover