In a recent study published in JAMA Network Open, researchers from UC San Francisco revealed that the US health system is ill-prepared to cater to elderly individuals living alone with cognitive impairments like dementia.

The term Cognitive Impairment refers to difficulties with mental abilities such as memory, attention, problem-solving, and decision-making, often due to brain damage, disease, or age-related changes. It can range from mild to severe, affecting daily life and independence.

A drawing of an elderly man and woman

Many US seniors live alone

Approximately 1 in 4 older Americans with these conditions lives alone, exposing them to risks like mishandling their medications, missed medical appointments, and wandering off and getting lost or worse.

The study, which involved interviewing 76 healthcare providers across California, Michigan, and Texas, highlighted concerns about these patients falling off medical radars due to forgetfulness or lack of follow-up capabilities. Many patients lacked emergency contacts, leaving them vulnerable to undiagnosed conditions and self-neglect.

US system lacking

Often, these patients only entered the healthcare system after a crisis. Lead author, Elena Portacolone,  PhD, MBA, MPH, of the UCSF Institute for Health and Aging, criticized the US system for not subsidizing home care aides adequately, contrasting it with better provisions in Europe, Japan, and Canada.

Seventy-nine percent of Americans with cognitive decline earn too much to qualify for Medicaid-subsidized care but can’t sustain out-of-pocket expenses over time.

The study calls for enhanced support, funded by expanded Medicare and Medicaid, emphasizing the increasing need as the aging population grows.

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