In anticipation of a stark increase in Alzheimer’s diagnoses in the coming decade, California state legislators are in the early stages of reviewing a bill that could alter care for dementia patients in years to come.
Senate Bill 48, the bill championed by state Sen. Monique Limón, D-Santa Barbara, would require all general internists and family care physicians to receive at least four hours of dementia training every two years as part of Continuing Medical Education. This would be a small portion of the 50 hours of CME physicians are already required to complete by law every two years.
For Sen. Limón, this bill really hits home. After her grandmother, Genoveva Gil, was diagnosed with Alzheimer’s, the senator recalled watching her family members care for her grandmother until her death in 2019. It’s for this reason that she has consistently drafted Alzheimer’s bills since her term in the legislature began in 2016.
“This became an issue that I lived in a really personal way,” Sen. Limón told the News-Press. “I watched my aunt and uncle and mother provide 24-hour care, and I really understood how difficult it was for families to care for individuals with Alzheimer’s and dementia. I got to live firsthand what that care looks like and what it feels like, and it’s very difficult.”
At a time when officials and community advocates are eyeing an anticipated increase in Alzheimer’s cases over the next five years, this bill aims to equip primary care physicians with the tools to diagnose Alzheimer’s faster and develop a treatment plan. An estimated 690,000 Californians currently have Alzheimer’s disease, and this number is projected to grow by 21% in the next five years, according to data from the Alzheimer’s Association.
As this number grows, officials are concerned about the limited capacity of the current health system to properly diagnose Alzheimer’s and dementia patients. Currently, the state has only 590 geriatricians to care for the 5.8 million Californians age 65 and above. In addition, research from the Alzheimer’s Association suggests that a fourth of all primary care physicians received no residency training in dementia diagnosis or care.
“A lot of people are ultimately diagnosed through a neurologist or specialized geriatrician, and what we know in that case is there there are not enough specialists to meet the needs of that population,” Jared Giarrusso, the state’s government affairs director for the Alzheimer’s Association, told the News-Press.
He added that the association sees “primary care physicians as a critical entry point for individuals,” but many in this position do not feel equipped to deliver a targeted diagnosis.
In some cases, a formal diagnosis of Alzheimer’s is not even given, and if it is, it can take years of searching for the right physician to get a direct answer.
This is exactly what Leigh Cashman experienced when looking for answers about her father’s condition.
When Ms. Cashman began seeing deficits in her father’s memory, she and her mother sought out various doctors to get a formal diagnosis, but no one could offer any insight into what was going on, she told the News-Press.
Eventually, her father received a general diagnosis of Mild Cognitive Impairment, a diagnosis that marks the start of dementia. But as the disease progressed, the family could not find a physician who would diagnose his specific type of dementia.To this day, Ms. Cashman said her family does not know if her dad had Alzheimer’s specifically.
In her search years-long for answers about her father, Ms. Cashman approached the Alzheimer’s Association to ask for support, and the services she found at the organization not only helped her family process the disease, but it also set her on a path of impassioned advocacy.
For nearly seven years, Ms. Cashman has served as an Alzheimer’s Advocate in the Central Coast Chapter, meeting with local, state and even federal lawmakers to lobby for more funding and greater awareness of the effects of Alzheimer’s. In her time as an advocate, she’s sat down with congressional members in Washington D.C. and has regular meetings with both Rep. Salud Carbajal, D-Santa Barbara, and Sen. Limón.
When she advocates for Alzheimer’s research and funding, Ms. Cashman said she feels like she has her “dad on her shoulder.”
“You’re kind of like a warrior out there,” Ms. Cashman said.
With diagnoses of Alzheimer’s set to increase significantly in coming years, Ms. Cashman said her battlefield is widening as she now advocates for friends with early on-set of the disease.
“I’m not just fighting for my dad anymore, I’m fighting for my friends,” she said.
As SB 48 moves through multiple review committees in the state legislature, the bill could potentially make it out of the legislature and on to the governor’s desk in September, Sen. Limón said. The bill made it through a policy committee on Monday and is now moving on to a fiscal committee for review. Even in its early stages, Sen. Limón said the bill is receiving bipartisan support and she is hopeful for the lasting change it can bring.
“I believe this bill has the potential for great impact to address Alzheimer’s care … we’re asking general care physicians to have a tiny bit of training, and we’re asking them to better understand what they should be looking for so they can better advise the patient and the patient’s family,” Sen. Limón said.