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Sep 24, 2020

Chris Callahan (of Indiana University) and Lee Jennings (University of Oklahoma) have some righteous anger. Why do we have comprehensive cancer care centers and not comprehensive dementia care centers? We have a body of evidence dating back 30 years to support people with dementia and their caregivers with Comprehensive Dementia Care. Lee Jennings added to this robust body of work with a study published in the Journal of the American Geriatrics Society demonstrating that a comprehensive dementia care program based out of UCLA reduced ED visits, hospital length of stay, increased hospice enrollment, and delayed time to admission to long term care. As Chris Callahan notes in his accompanying editorial in JAGS, a fundamental problem with our healthcare system is that savings from Comprehensive Dementia Care accrues not to the dementia care program, but to the hospital and Medicare (ED visits, hospital length of stay) or Medicaid (long term care admission). Our fragmented healthcare system lacks the coordinated big picture financial incentives to make this happen for our patients. One more major point - Chris Callahan emphasizes in the podcast that we as clinicians need to stop saying, "there's nothing that we can do for dementia; nothing works." That's simply not true. While we lack Comprehensive Dementia Care programs in nearly every region of the US, we have tremendous community resources for people with dementia and their caregivers. The Alzheimer's Association is a great place to start. The song request was This Land is Your Land, classic Woodie Guthrie as Lee Jennings works at the University of Oklahoma. Chris Callahan rewrote the lyrics to address the topic, and if you listen to the very end of the podcast, you'll get this version: This land needs dementia care Comprehensive dementia care From California to Indiana From Oklahoma to the New York Island We need dementia care for our families As I sought clearly, the research to frame I saw clear data of the triple aim I saw the workforce, we need to train We need dementia care for our families -@AlexSmithMD