Understanding Dementia: What Medicare Beneficiaries and Their Families Should Know

Dementia affects millions of adults and their families across the United States. For individuals and those that care for them – understanding dementia is an important first step toward early detection, better care and improved quality of life. In this article we'll discuss what dementia is, what to watch for, supporting brain health, help from your health plan and how families are affected.

What is Dementia?

Dementia is not a single disease. It is a term used to describe a decline in memory, thinking and reasoning skills that interfere with daily life. These changes can affect a person’s ability to manage everyday tasks and live independently. The most common form of dementia is Alzheimer's disease, but other conditions can lead to dementia, including vascular dementia, which is related to reduced blood flow to the brain, and frontotemporal dementia, which affects behavior and language.

Early Detection: Why it matters and signs to watch for 

Early detection can make a significant difference for individuals and their families by helping them access treatment and support services sooner. It also allows time to plan for future healthcare and financial decisions, learn strategies to maintain independence longer and connect with community resources and caregiver support. For Medicare beneficiaries, Annual Wellness Visits (AWV) often include cognitive assessments that can help identify potential concerns.^*

Recognizing the early symptoms of dementia can help individuals and families seek medical advice sooner. Common warning signs include: 

• Memory loss that disrupts daily life
• Difficulty planning or solving problems
• Trouble completing familiar tasks
• Confusion with time or place
• Problems with words in speaking or writing
• Misplacing items and being unable to retrace steps
• Changes in mood, personality or judgement

If you or a loved one notices these symptoms, it’s important to talk with a healthcare provider. Early evaluation can help determine whether the symptoms are related to dementia or another treatable condition. 

Supporting Brain Health

Healthy lifestyle choices can support overall wellness and may play a role in maintaining brain health over time.

Staying Physically Active 
A great way to do this is to use the One Pass^® benefit to explore local gyms and work out facilities.

Eating a Balanced Diet 
Check out dozens of healthy recipes on the Trinity Health website.

Managing Chronic Conditions 
Work with your healthcare provider to address conditions such as high blood pressure and diabetes. Read our previous blog post about managing Diabetes.

Staying Socially Engaged 
Did you know that One Pass also offers a social aspect through Grouper? One Pass organizes in-person social activities where you can meet people with similar interests and build friendships to enhance your overall wellness.

Keeping the Mind Active 
Engaging in learning activities and hobbies can help support overall brain health. Check out our blog post, Digital Screen Time Awareness: Finding a Healthy Balance, to read about ways to reduce screen time and exploring new interests.

These activities boost overall health and may help reduce the risk of cognitive decline. 

Support from your health plan

We have benefits and services to support you or your loved one on the journey with dementia. 

Cognitive Tests and Assessments
Usually this is included in an AWV, and if it is not, you can request that a provider perform one. A specialist can also perform a cognitive test and can create a care plan. In addition, you should also ask your provider to perform a depression screening to help understand if depression might be causing the symptoms.

Provider Visits and Medical Treatment
Visits to neurologists and psychiatrists if needed are covered with low cost-sharing.

Prescription Medication 
If you are part of a plan with Part D coverage, there may be medications in our formulary that might require a copay that can help treat symptoms. Our plan covers commonly prescribed medications for dementia, including memantine and donepezil. Be sure to consult your prescriber before making any medication changes and review our plan's formulary for the most current coverage information.

Home Health Care
If a doctor certifies this is necessary and that you are homebound, services such as speech therapy, occupational therapy and physical therapy could be provided in your home. 

Caring for someone with Dementia 

Dementia affects more than just the individual diagnosed — it also impacts family members and others who help care for them. As the condition progresses, caregivers may experience emotional, physical and financial stress, making support an important part of the overall care journey. That support may come from family and friends, community support groups and local ageing agencies. The MercyOne Health Plan Case Management team can also help connect caregivers with local resources and services.

You're not alone

Dementia can feel overwhelming, but support, education and awareness can empower individuals and families to take actions. If you have concerns about memory or cognitive changes, start the conversation with a healthcare provider.

*A copay may apply if you are treated for an existing medical condition during one of these no cost preventive service visits. Refer to Chapter 4 of your Evidence of Coverage for more details.

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Sources
What is Dementia? Symptoms, Causes & Treatment | alz.org