People living with Alzheimer's face unique safety challenges in community settings. Public health must address these challenges through increasing awareness, preventing abuse and exploitation, addressing potential self-neglect and promoting care planning.

What public health can do

Public awareness: Public health practitioners can increase public awareness about situations that may be dangerous to people with severe cognitive impairment. Better public awareness can help families recognize warning signs and develop safety plans to minimize these risks.

Possible risk situations include:

Preventing abuse and exploitation: Educating the public is vital for preventing abuse, neglect and exploitation (including financial exploitation) of people living with dementia. As cognitive impairment worsens, people can become increasingly vulnerable to mistreatment. A person living with dementia may not recognize actions that could be harmful and have difficulty protecting themselves or may have difficulty recognizing suspicious or criminal activity. People living with dementia may experience problems communicating that hinder reporting or seeking help.

Addressing self-neglect: Cognitive impairment may also increase the risk of self-neglect for people living alone with dementia, especially as the ability to perform activities of daily living gradually declines. The public health community can actively strive to prevent self-neglect through partnerships with adult protective services, law enforcement, aging network service providers and other community-based organizations.

Care planning: Because Alzheimer’s complicates the management of other chronic diseases, professional care planning — particularly by interdisciplinary teams — is key to coordinating and managing care. Care planning allows people with dementia diagnoses and their caregivers to:

  • Receive a comprehensive assessment.
  • Learn about medical and non-medical treatments.
  • Secure relevant services in the community that can support a higher quality of life.

People receiving care planning specifically geared toward dementia have fewer hospitalizations, fewer emergency room visits and better medication management.

One way the public health community can help promote care planning for people with cognitive impairment is to educate health care professionals about offering reimbursable care planning services. CPT® billing code 99483 allows clinicians to be reimbursed for providing a comprehensive set of care planning services to people with cognitive impairment and their caregivers.  

Learn more: Care Planning for Cognitive Impairment.

Featured Resources

Centers for Disease Control and Prevention Elder Abuse and Violence Prevention Center
Health Resources and Services Administration Training Curriculum: Alzheimer’s Disease and Related Dementias
National Center on Elder Abuse National Center on Elder Abuse Resource Center

Safety and Injury Prevention Resources

Safety and Injury Prevention Implementation

CO Colorado Department of Public Health and Environment Training webinar for health care facilities and providers about how to safely evacuate persons with dementia during an emergency
LA Louisiana Department of Health Assessed the awareness, experiences and training needs of Baton Rouge Police Department staff with respect to Alzheimer’s and other dementias, especially in regards to wandering behaviors; the assessment also included an educational component.
MN Minnesota Department of Health Minnesota Department of Health is partnering with residential care facilities to ensure emergency preparedness plans address the needs of people living 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.
WA Washington State Department of Health Implementing the Healthy Brain Initiative Road Map: A Toolkit for Public Health Organizations