Comments on Medicare Proposals on Improved Hospital Care for Dementia Patients
Michael Ellenbogen wants to encourage anyone interested to make comments on this measure. I am going to include Michael's comments:
Please get people to make comments on this site ASAP. Very important.
You must submit your comments by June 10 on the Regulations.gov site.
Pls see the proposed CMS Measure link added here. There is time for public comment until June 10 on the age-friendly measures. Will go a long way to an eventual requirement and The Joint Commission then would have to address.
This is something I have been working on for 10 years now. Not sure if I could add my make recommendations to the existing recommendation of CMS-1808-P or do they need to add an addendum for our part I have been working for if we were to succeed.
Thes are my comments below that I will add.
While much of this is over my head I did read the CMS-1808-P. So, I went by the short version and hope I did not misunderstand. I have learned that there are many ways to fix a problem. Sadly, if not fixed effectively it just creates other or new issues. If this was the 1970’s I would have said this is good. But this is 2024 and just in the last 5 years we have learned so much when it comes to Neurological disease (ND). There are also many people without diagnosed ND that experience cognitive dysfunction from stress, drug interactions, delirium, etc. that could be cured and they don’t even know it. The medical treatment these people experience is impacted by their diminished ability to understand and engage fully with a treatment regimen or provide a reliable medical history. This also dramatically affects their treatment within the hospital system.
The first mistake in this document is to think that when someone turns 65, and only then, those issues begin. Sadly, that is so far from the truth and people under 65 years of age also need to be treated fairly. Then of course we have learned so much in the last few years around dementia and other ND. None of this information is even in the textbooks currently so our existing medical staff is far from understanding this and they are left in the dark because hospital administrators refuse to pay for additional education on dementia care. That brings me to the next point as to why a certification program is needed to hold hospitals accountable. Lack of education is one of the biggest issues we face. Not just when it comes to people diagnosed with dementia. Over 50 percent of those with dementia don’t even know they have it. That is why we need to identify these folks as they enter the system so we can ensure they get the necessary help they deserve. Could you imagine being admitted to the hospital and not understanding what you need to do in order to get better. This happens all the time. Especially for low income and underserved populations. Let’s create a true and fair hospital system where all people are treated fairly so they can get the quality medical care they deserve. People need to be tested/identified to ensure they are able to care for themselves. People as young as 19 years old could be impacted by this, for various health issues.
As a person who was a caregiver and has spoken to thousands of people living with dementia, and their caregivers, I have had heard so many horror stories, including my own as I live with dementia myself. I come from the IT field and our goal was to actually determine the real root cause of the problem, and actually fix it. Anything else was just putting a Band-Aid on it, that always created some other unknown issue. So, lets stop the inequity. This should not be about the money, but real quality medical care. I contacted a website that was promoting the 4M’s and asked them what will this do for me, as a person who is living with dementia. Simple answer, nothing. So, you be the judge on how great this is.
Again, I am going by the short version of the proposed rule. I think there are some good things in there. There are three points I find lacking: 1. Including those below the age of 65, 2. The extremely important piece of providing education on caring for those with dementia/cognitive dysfunction, and 3. A way to communicate to the entire healthcare team those identified with cognitive dysfunction through the admission screening.
You may be interested in the article I had recently published on this exact issue.
