Thesis

Non-Pharmaceutical Interventions for Alzheimer's Disease and Related Dementias: A Review of Medicaid Coverage

Abstract Non-Pharmaceutical Interventions for Alzheimer's Disease and Related Dementias: A Review of Medicaid Coverage By Demetria Dugas Master of Public Administration, Health Administration The growing population of individuals age 65 and older has brought about an increased demand for healthcare services; particularly interventions targeting the effects Alzheimer's disease and related dementias. The traditional care model for those diagnosed with Alzheimer's disease consists of drug therapies to combat undesirable behaviors and eventual residency in a long-term care facility; a model that incurs considerable expense to Medicaid. This literature review seeks to examine the benefits of various nonpharmaceutical interventions currently utilized with individuals diagnosed with Alzheimer's disease, and the Medicaid policies of community-based services and durable medical equipment that could be utilized to cover their expense. Current articles were collected using Wiley Journals, Sage Journals, PubMed, OneSearch, JSTOR, and Google Scholar using the key search terms: Medicaid coverage of Alzheimer's treatments, Medicaid policy Alzheimer's treatment, costs of Alzheimer's disease, Alzheimer's pharmaceuticals, nonpharmaceutical treatment of Alzheimer's, Medicaid durable medical equipment, Money Follows the Person Program, Medicaid In Home Support Services, and Program for All-inclusive Care for the Elderly . Government websites for CMS, Medicaid, and the state of California were searched for information regarding Medicaid policies. Studies showed that non-pharmaceutical interventions such as music listening, time in nature, and use of technology were effective against undesirable behaviors such as apathy, disordered sleep, and agitation in patients with Alzheimer's; however, Medicaid/Medicare provides no direct coverage for these types of therapies. Medicaid policies of providing community based services to assist with activities of daily life, acute and primary care, and even transportation have been implemented in an effort to decrease beneficiary transitions to long term care; however barriers such as housing and limited personal support prevent some individuals from having sufficient access to the benefits of these programs. More research is necessary to determine if greater use of community-based services, coupled with implementation of alternative therapies, results in decreased use of pharmaceuticals for treatment of adverse behaviors and transitions to long term care; both of which would result in financial savings for Medicaid.

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