Alzheimer's places a huge burden on the health care system, with annual costs of $321 billion in 2022. People living with dementia are hospitalized more often, have multiple complicating chronic conditions, and represent a large share of costly residential care.

Quality dementia care requires a person-centered focus. Person-centered care is built around the needs of the person living with dementia, and requires that the health care team understand the unique needs and desires of that individual. To help better define quality care across care settings and throughout the disease course, the Alzheimer's Association drafted the Dementia Care Practice Recommendations in 2018. They were based on a comprehensive review of current evidence, best practice, and expert opinion. 

What public health can do

Educate health care professionals: Quality care is influenced by numerous aspects of the health care system, including access to care, well-trained providers, and safe and reliable care settings. Public health can use its broad authority to ensure people with dementia and their caregivers receive quality care across each of these aspects. State, local, and tribal public health agencies can promote early detection and diagnosis and educate and train professionals to help meet these needs. 
 
Educate policymakers: Public health officials can educate policymakers and other government officials about evidence-informed standards that best ensure quality of care for people with dementia.

State success: Clinical care guidance in California

In 2017, the California Department of Public Health (CDPH) published and distributed an update to its Clinical Care Practice Guidelines for Alzheimer’s Disease. The update incorporated the latest scientific evidence and best clinical practices. CDPH promoted the guidelines to practicing clinicians statewide and used them to encourage early detection, risk reduction, and quality care. In 2018, CDPH published a companion toolkit, the Assessment of Cognitive Complaints Toolkit for Alzheimer's Disease (ACCT-AD).

See the Toolkit

Featured Resources

Alzheimer's Association Financial & Legal Planning
Health Resources and Services Administration Training Curriculum: Alzheimer’s Disease and Related Dementias

 
Quality Care Resources
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Quality Care Implementation
State:

AZ Arizona Department of Health Services To help expand caregiver support statewide, the Arizona Department of Health Services launched and joined the Arizona Dementia Caregivers Alliance (with over a dozen additional organizations). As part of this Alliance, partnered with a community organization (Duet) to expand its caregiver support programming through local health departments.
AZ Arizona Department of Health Services With partners, Arizona Department of Health Services conducted a comprehensive needs assessment of people living dementia and caregivers in the state, assessed providers to identify gaps in existing services and supports for people living with dementia and caregivers, and developed a three-pronged approach to address these issues
CA Department of Public Health California Department of Public Health worked with California Alzheimer’s Disease Centers to update the Alzheimer’s Clinical Care Guideline and provide a toolkit for community practitioners on early detection and diagnosis in support of the updated guideline.
CO Colorado Department of Public Health and Environment Trained nearly 100 first responders how to effectively interact with people living with dementia, and created and distributed the workplace poster, Tips for EMS Working with People with Alzheimer’s to remind trainees of best practices.
FL Florida Department of Health Incorporated Alzheimer’s disease into the State Health Improvement Plan, which guides how FDOH and its partners will improve the health of Floridians.
GA Georgia Department of Public Health Department of Public Health trained clinical staff (70 physicians and 75 nurse practitioners) about dementia and the need for increased awareness and diagnosis.
IL Illinois Department of Public Health Developed and deployed dementia-specific training for all direct care workers in residential settings, and in home- and community-based settings. IL DPH hosts training and monitors compliance across the state.
IL Illinois Department of Public Health The Illinois Department of Public Health partnered with the Illinois Public Health Association to conduct a webinar with continuing education units to educate public health professionals about the role of local public health agencies in promoting early detection and diagnosis of Alzheimer’s and other dementias.
KS Kansas Department of Health and Environment Increased public awareness of risk reduction messages to enhance early detection and reduce stigma via a partnership with the Kansas State Extension Office; trained almost 50 Extension Officers to educate Kansans about Alzheimer’s and brain health in counties across the state.
LA Louisiana Department of Health Educated LDH supervisors about workplace support for caregivers (especially employees caring for people living with dementia); the online training module is available to supervisors in all state agencies, and Louisiana social workers can receive continuing education for successful completion of the module.
LA Department of Health Louisiana Department of Health conducted a workshop for its employees on advance care and advance financial planning.
MD Maryland Department of Health Promoted advance directives by collaborating with: 1) the Maryland Faith Health Network, which educated more than 500 Marylanders about advance care planning through health fairs, faith-based events, and end-of-life educational seminars; and 2) three local health improvement coalitions, which educated almost 150 participants in seven courses on advance planning.
ME Department of Health and Human Services Distributed the State Plan for Alzheimer’s Disease and Related Dementias in Maine – a special insert for health care providers on cognitive assessment tools, early detection, and the value of early diagnosis – to primary care professionals through hospital and health systems.
MN Minnesota Department of Health Educated community health workers on the oral health needs of people living with Alzheimer’s and other dementias by developing a curriculum and partnering with institutions that train these workers.
MN Chisago County Public Health Department Chisago County Public Health Department supported training of local law enforcement officers and first responders on how to effectively communicate with and serve people with dementia.
MN Department of Human Services Minnesota Department of Human Services established a common point of entry for reporting abuse, neglect, and exploitation of vulnerable adults statewide, including those with dementia.
MO Missouri Department of Health and Senior Services Missouri Department of Health and Senior Services adjusted level of care assessment for Medicaid in-home services to better meet the needs of people living with dementia
MT Montana Department of Public Health and Human Services Medical Director sent a "Dear Colleague" letter about the benefits of early detection and diagnosis to the Nurses Association, Medical Association, and Hospital Association.
NM New Mexico Healthy Aging Collaborative New Mexico Healthy Aging Collaborative includes “cognitive health” as part of its multi-agency effort to support elders in New Mexico.
NY New York State Department of Health New York State Department of Health, through its partnership with the University of Albany, conducted an online training for health care providers: Determining Caregiver Needs and Well Being.
NY New York State Department of Health The New York State Health Commissioner sent a November 2016 ‘Dear Colleague’ letter, encouraging health care providers to “play their part in the early detection/diagnosis of Alzheimer’s Disease and other dementias.” The letter highlights dementia prevalence data and various resources, including the NYS Alzheimer’s Disease Support Initiative
NY New York State Department of Health New York State Department of Health partnered with University of Albany to provide free CME online training for primary care physicians, along with informational resources and tools.
NY New York State Department of Health To address disparities, the New York State Department of Health funded a two-year referral and outreach demonstration project that primarily serves African-American and Hispanic communities
PR Departamento de Salud Created and promoted a 6-CME/CEU educational module, Alzheimer’s Disease: Early Detection and Diagnosis, for physicians, nurses, psychologists, health educators and social workers.
RI Rhode Island Department of Health Established a new program — Alzheimer's Disease and Related Disorders — within the Rhode Island Department of Health to better assess and track state progress on risk reduction of cognitive decline and meeting the needs of people with dementia.
TN Tennessee Department of Health Educated public health professionals about cognitive health, health indicators, diagnosis, and community resources via an issue brief developed from original data analyses and conducted a live training webinar to discuss findings and implications for public health practice.
TX City of San Antonio Educated and trained all transit employees, senior center employees, and police department staff on Alzheimer’s basics, early warning signs of dementia, and dealing with people with dementia.
UT Utah Department of Health Promoted early detection and diagnosis of Alzheimer’s and other dementias by documenting cognitive assessment practices during Medicare Annual Wellness Visits; disseminated study findings to all Utah primary care physicians; and, distributed a list of resources for people with cognitive impairment along with a recommendation from UDOH’s executive director for routine cognitive screening during the Annual Wellness Visit.
UT Utah Department of Health Utah Department of Health contracted with Health Insight (a quality improvement organization) to query primary care providers about current efforts and challenges related to assessing for cognitive impairment and caring for people with dementia.
WA Washington State Department of Health Implementing the Healthy Brain Initiative Road Map: A Toolkit for Public Health Organizations
WI Wisconsin Department of Health Services Collaborated in implementation of state Alzheimer's disease plan by helping develop a caregiver road map titled Dementia Road Map: A Guide for Family and Care Partners.
WI Wisconsin Department of Health Services Developed online training for family caregivers of people with Alzheimer’s disease or other dementia and provides a list of resources for caregivers
WI Wisconsin Department of Health Services Wisconsin Department of Health Services and a designated group of stakeholders, the University of Wisconsin Oshkosh (UWO), Center for Career Development and Employability Training (CCDET) is developing a series of free, online trainings related to dementia care for crisis responders, caregivers, healthcare providers, family and community members, and other professionals. A Spanish-language version is available.