08/30/2025
This is a very important eye-opener! PLEASE read!! Many of us children are in denial and don't want to put our parents in a community because we feel guilty. Luckily, I'm not there yet, but I know many who are and the BEST thing you can do for your mom or dad is move them into a memory care community. What will they do when you are not there to take care of them anymore? You are the one that will go down! Trust me, I know, I see it every day. - Donna Nichols
New idea for dementia care being put to test
Medicare pilot program provides non-medical help
Anne Geggis
Palm Beach Post USA TODAY NETWORK – FLORIDA
In no way are centenarian birthdays what they used to be: Residents at Elison Independent Living in Lake Worth have celebrated breaking past the 100year mark eight times in the past three years.
Soon, it seems, avoiding the Grim Reaper's reach for a full 100 years will be remarkable enough to make the evening news only if said oldster also wins the day's pickleball tournament and recites the Gettysburg Address just before blowing out all those candles with an impressive gust of breath.
That bit of hyperbole aside, there's no denying that the ranks of the very old — those older than 80 years — are growing at an unprecedented rate. Between 2020 and 2050, the world's octogenarians and older are expected to triple to 426 million people, according to the World Health Organization, and it's going to be the fastest-growing segment of the U.S. population, according to National Institutes of Health research.
That swelling of the super elderly ranks poses unprecedented challenges to how health care for senior citizens is set up now.
Mildred “Millie” Antonich (left), and her daughter, Suzanne Antonich, enjoy a meal out about two years before her death on Dec. 26, 2022. PROVIDED BY SUZANNE ANTONICH
After age 65, the National Institutes of Health estimates, the likelihood of developing dementia doubles every five years.
It's expected that the number of Americans who hear the news that they have dementia will double from the 500,000 that heard it in 2021 to 1 million people annually in 2060.
As the super elderly make up a greater and greater proportion of the population, it has government officials and gerontology researchers battling the clock
in looking for new ways to address emerging needs.
Slow-moving crisis gaining momentum
Dementia is a slow-moving disease with different stages. The course of the disease can last as long as 20 years with symptoms not severe enough to warrant hospitalization or medical treatment that would be covered by Medicare. But during the mid- to late stages, patients may need help with the activities of daily living, such as cooking, dressing, bathing and going to the bathroom. And those needs are largely unaddressed by traditional Medicare and Medicare Advantage.
The sheer magnitude of what caring for her mother would mean hit Suzanne Antonich, 67, like a truck — and just as suddenly, she said. Soon after her mother moved in with Antonich, the Palm Beach Gardens resident realized her then-88-year-old mother's dementia posed a deadly risk.
“She had put a pot on the stove with eggs in it and forgot it was on the stove,” Antonich said. “Fortunately, I came home right when the eggs were smoking with no water in the pan.”
The incident made it clear what she had to do next: quit her job as a newspaper advertising manager.
“It was like, 'Jesus, she could have burned down the whole place here,' ” Antonich said. “Right then, I knew I couldn't leave her alone.”
For the next five years, ending with her 93-year-old mother's death the day after Christmas in 2022, Antonich was on what she calls “the hardest journey of my lifetime.”
Does Medicare pay for assisted living or skilled nursing care?
Medicare pays for the first 100 days in a nursing home if skilled care is needed, such as changing a sterile wound dressing or getting injections. Some in-home help is also covered, if the same sort of medical care is needed.
But there was nothing for what Antonich needed to care for her mother: companionship, bathing and help with eating, to name a few.
Toward the end, Antonich was struggling to get her mother, who weighed 200 pounds to Antonich's 110 pounds, to the bathroom. Incidents that terrified her happened, she said, like the time her mother passed out on the toilet.
“The public EMT (emergency medical technician service) here, I had their number on speed dial,” she said. “They would come and help pick her up, set her up, get her back in the chair.
“I never had such high stress.”
A Medicare pilot opens the door to non-medical care — a crack
With an eye on the emerging reality that many Americans will be outliving their ability to function independently, Medicare last July started an eight-year pilot that, in some cases, will provide non-medical care to people with a dementia diagnosis. Nationally, it involves 330 organizations, some based in 19 Florida cities and others serving Florida through national, out-of-state home care providing chains.
The program is called GUIDE (Guiding an Improved Dementia Experience) and seeks better ways to provide medical and non-medical care to dementia patients. And already it's having an impact, albeit somewhat small, on local caregivers.
Right at Home, a service that sends paid caregivers to local homes, started qualifying its patients for Medicaresponsored hours of service in July, so their caregivers can take a break from tasks such as bathing the patient, making meals and helping them get up from the bed to a chair.
“Medicare never paid for this,” said Sidney Chugani, owner and president of Right at Home Dania Beach. “Now they have realized this is such a big concern. So many seniors, aging in place, can't be left alone if they need memory care.
“It's really good they are recognizing the need,” he added.
Out of Chagani's 40 clients, seven of them have qualified for 76 hours of inhome, nonmedical care paid through Medicare each year.
Antonich says that meeting her mother's needs took more time than that within a week, let alone a year.
Antonich contemplates the future, knowing that no one will be there for her, like she was for her mother.
She has no children — also an emerging trend, demographically speaking. She said she also thinks of the aides who helped her through the rough patches that she would hire using her and her mother's savings when she was desperate to get away for a few hours.
“If all the Spanish (speaking) people and everybody are going to be gone, who's going to be doing all those jobs?” she asks rhetorically, referring to the federal crackdown on undocumented immigrants. “Ninety percent of who came were young, Spanish (speaking) people. (They) were happy making $10 an hour. What Americans are going to help people into wheelchairs and take them to the bathroom and do whatever else they need to do for 10 bucks an hour?”
Specialists in the care of older people are in a race to develop preventive measures that will keep people in their homes and prevent chronic conditions as much as possible. A Medicare report that trustees released June 18 shows that, if all trends continue, the government will not be able to sustain the current level of benefits by 2033, three years earlier than last year's report. And that's just the critical care.
Reducing the risks of falls
Professor Ladda Thiamwong is leading an interdisciplinary team of experts at University of Central Florida to develop a technology- and community-based approach to fall prevention, which is the leading cause of injuries and hospitalizations.
The team received a $2.3 million grant in partnership with the city of Orlando to prevent falls and reduce the expenses that occur when they happen.
Thiamwong has developed and tested a fall assessment that uses technology, such as portable sensors to measure balance, to provide information aimed at encouraging not only muscle development but also seniors' confidence about getting out and participating in life. Thiamwong sees community support and individual health as key to filling in the gap between being able to live independently and being in a nursing home or hospital.
“We should start to talk more about education, empowerment and the collaboration between older people and the community,” Thiamwong said.
For Antonich, however, her own family was not interested in easing her mother's decline.
“I have three brothers — three brothers — and none of them were any help,” she said, recalling how she tried to take a cruise to get away for a week. “They didn't want to come to give me a break. It's always the daughter that ends up doing whatever a parent needs.”
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