During my five years with the Department of Health and Welfare the state’s three psychiatric hospitals have made incredible strides to improve their level of service for Idahoans. The Southwest Idaho Treatment Center, a center that serves people with developmental disabilities, has also achieved incredible milestones.

The three state hospitals—North, South, and West—are managed by the Division of Behavioral Health. Southwest Idaho Treatment Center (SWITC) is managed by the Division of Family and Community Services.

State Hospital West

State Hospital West is a 16-bed adolescent psychiatric facility that opened in May 2021 in Nampa for youth ages 12 through 17. State Hospital West was accredited this month by The Joint Commission, the nation’s oldest and largest standards setting and accrediting body in healthcare. 

Accreditation is a significant accomplishment that demonstrates the hospital’s ongoing commitment to continuous improvement in patient care. 

State Hospital West provides a secure setting where youth receive more intensive comprehensive behavioral health services than they could in a community hospital, and they receive it 24 hours a day, 365 days a year.

State Hospital South

State Hospital South in Blackfoot and State Hospital North in Orofino serve adults civilly committed to the state for treatment of a mental illness or to be restored to competency for criminal proceedings.

State Hospital South is Idaho’s oldest and largest state hospital. It opened in 1886 and has a 110-bed psychiatric facility and a 42-bed skilled nursing facility for seniors called Syringa Chalet. State Hospital South has been Joint Commission accredited since 1998.

When State Hospital West opened in 2021, it made space available at State Hospital South where adolescents had previously been housed. State Hospital South was subsequently converted into a more secure unit.

Syringa Chalet was also expanded during my time with the department. It became a skilled nursing facility in 1990 and was expanded from 29 to 42 beds when it moved into a new building in 2020.

State Hospital North

State Hospital North in Orofino is working toward accreditation by The Joint Commission. When achieved, this will be a reflection of the hospital’s commitment to meeting established performance standards for care and safety.

State Hospital North is working closely with with accreditation consultants to identify gaps and make recommendations to boost safety and achieve best practice standards. This has resulted in many positive changes at the hospital that will benefit both staff and patients for years to come. I’m confident the hospital will be accredited in the near future. 

Joint Commission accreditation, once achieved, will allow the hospital to bill Medicaid and Medicare for services provided to patients covered under those insurance plans. 

Southwest Idaho Treatment Center (SWITC)

The mission of Southwest Idaho Treatment Center (SWITC) in Nampa is to provide services as a short-term therapeutic stabilization and transition center for clients, focused mostly on those who have criminal activity or severe behaviors. 

SWITC has become a stabilization center for people with intricate and challenging needs, with the goal of transitioning them to effective community placements for long-term services.

SWITC is undergoing a major overhaul as part of the Crisis System Improvement Project. Outdated or unused buildings have been razed, and construction will soon begin on an assessment and observation unit, and transitional step-down units. 

The project team also explored licensing and accreditation types for future services and is field testing elements of the proposed new treatment model. The project team is working with the Centers for Medicare and Medicaid Services to establish federal funding for future services.

I’m also proud to report that SWITC received compliments for positive improvements in a recent July 3 investigation by the Idaho Office of Performance Evaluations (OPE). 

Thanks to the teams who do this work

The strides made by the three state hospitals and SWITC are nothing short of commendable, and the staffs in Orofino, Nampa, and Blackfoot deserve the credit. Their concerted efforts have resulted in significant improvements in patient care and services, and I’m proud to have been a part of the work during my time with DHW.

These accomplishments help underscore that Idaho's mental health landscape is evolving positively, with a shared commitment to the well-being of Idaho citizens. 

I hope you have a safe and healthy weekend! 

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

During the past year the Department of Health and Welfare has worked to make sure that those eligible for health insurance through Medicaid remain enrolled. One of our chief concerns through that process has been to keep eligible children covered—a concern shared by our federal partners in a letter to Gov. Brad Little this week.

Medicaid provides health insurance coverage to eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. Normally, federal regulation requires states recertify eligibility of Medicaid enrollees annually. 

During the COVID-19 pandemic, enrollees could generally not be disenrolled even if they became ineligible, such as earning above the income threshold. Federal law temporarily required states to maintain Medicaid coverage for adults and children unless they died, moved out of state, or asked to be removed. This was called Medicaid Protection.

As the pandemic progressed, even though states could for the most part not disenroll members from Medicaid, we ran a series of tests of all automated renewal processes to simulate the end of Medicaid Protection. This ensured that our eligibility determinations would be accurate and, for those found ineligible, our electronic hand-off to the state-based exchange would work. The goal: help everyone find the coverage they need and qualify for.

That temporary pause on continuous eligibility for all enrollees ended this year. States submitted their “unwinding” plans to verify enrollee eligibility and continue coverage for eligible participants. Idaho’s plan prioritized enrollees, such as first processing renewals for enrollees who, based on available data, appeared no longer eligible. Idaho’s unwinding plan was approved and subsequently executed. 

Meanwhile, as soon as the department learned that the pause on disenrollments would end beginning April 2023, we began reaching out to Idahoans and community partners and going through records to figure out who qualifies for health insurance through Medicaid, and who does not. Doing so accurately and efficiently has been a top priority. Making sure that Idaho children who qualify remain on Medicaid has been of utmost importance.

Reexamining eligibility has been a large, complex and important undertaking that DHW has taken very seriously. Here are some examples of what we’ve done to try to ensure those who qualify remain covered:

• Staff were and are available to support all eligibility questions and complete reassessments to ensure accurate and timely coverage is provided. An individual can come into a field office, call, or go online to our mobile friendly application, Idalink, to check eligibility and, if needed, will receive coverage retroactively as far back as 90 days. 
• Idaho provides continuous coverage for kids. This means, once a child is enrolled in Medicaid, that child’s coverage will continue for one full year, even if during the course of that year the child becomes ineligible. Starting in January, this will be required for all states. In Idaho we’ve been doing it since 2020, long before it was required.
• We reviewed all our processes to ensure accurate outcomes. 
• We partnered with federally qualified health centers (FQHCs) that serve Medicaid participants to conduct targeted outreach to ensure families were aware of the need to provide updated information for redetermination efforts. 
• Multiple outreach efforts were made to Medicaid members to inform them of the end of continuous enrollment and the need to update their information, including traditional mail, email, and text messaging.
• We’ve specifically coordinated with Idaho tribes to conduct onsite redetermination efforts to ensure continuity of coverage for eligible tribal members. We also met with multiple advocate groups like Voices for Children, Office on Aging, Idaho Health Care Association, hospitals, and food banks. 
• We ran multiple social media campaigns highlighting the end of continuous enrollment and urging enrollees to contact us.

Along the way our federal partners provided updated direction with clarifying guidance, requiring states to review existing processes to ensure accurate coverage was being provided during the unwinding process. 

Upon receiving this guidance, department staff immediately took action. We paused procedural closures and pivoted to review and adjust processes and systems accordingly. As a result, 18,000 individuals, 6,000 of whom were kids, had their coverage reinstated. 

Despite our outreach efforts aimed to keep eligible Idahoans covered under Medicaid, many previously enrolled Idahoans did not respond and were removed from the Medicaid program. Our latest data shows 51,000 children have been removed from Medicaid. While this number is 10% lower than our federal partner claims, even 1 eligible child removed is one too many.

We appreciate the concern expressed regarding loss of coverage for Medicaid participants in Idaho and share the goal of ensuring qualifying individuals, including children, remain eligible for Medicaid. 

We know that we’ve taken the appropriate steps over the last nine months to make sure qualifying children and adults get and maintain the health insurance coverage they need. The department has cooperated with federal and state partners to complete the unwind of continuous enrollment in an accurate, efficient and compliant manner. On two occasions, we paused our process to ensure that eligible Idahoans remained covered. 

Ultimately, Idaho followed the law, federal guidance, and our federally approved plan to complete our unwinding work.  Most other states are still in process, with some just beginning. As they complete their unwinding activities, it will be interesting to see how the numbers compare. 

In Idaho, anyone can apply or reapply for Medicaid at any time. If you or someone you know needs health insurance, please contact DHW at 877-456-1233 to see if you qualify.

The Department of Health and Welfare (DHW) tackles numerous challenges in its day-to-day service of Idahoans, and one of the biggest the department undertook during my tenure was mandated by Idaho voters.

In 2018, just a few months before I was appointed director, Idahoans went to the polls and enacted Medicaid Expansion, which expands Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level, which was $20,120 for an individual in 2023. 

In short, voters asked for more Idahoans to be eligible for health insurance through Medicaid. As the state agency that determines Medicaid eligibility and administers the program, DHW made that happen effectively and affordably. 

Enrollment began in November 2019, and coverage for those newly enrolled began in January 2020.

As of December 2023, around 94,587 Idaho residents were enrolled in Medicaid Expansion. These are individuals who have a monthly income of $1,563 or less, or a family of four with a monthly income of $3,192 or less.

Most of them, over 79%, have reportable income.

Some of them, 24% as of last winter, have a primary diagnosis of Serious Mental Illness. Medicaid Expansion allowed them access to a wider range of behavioral health services so they could get more comprehensive treatment. 

The cost of Medicaid Expansion is split with 90% paid for by the federal government and 10% paid for by the state. By comparison, for every dollar spent for traditional Medicaid, the federal government pays for about 70 cents, while the state pays for around 30 cents.

On average, people with a Serious Mental Illness live about 20 years less than others. Medicaid Expansion allows for more comprehensive treatment of both physical and behavioral health issues, which might help people live longer.

Containing costs is integral to making it work

Healthcare costs seem to increase each year, and containing Medicaid costs has been integral to implementing expansion.

The Healthy Connection Value Care Program focuses on paying healthcare providers for value, rather than volume. Medicaid participants are connected with a primary care provider who can help them make healthier decisions and get treatment before a condition becomes chronic and more expensive.

Going forward, Medicaid will need to continue the difficult and delicate balance of ensuring that individuals who qualify for Medicaid get access to the services that they need while managing the overall cost of the Medicaid program.

If you have questions about Medicaid, contact DHW at 877-456-1233 or email MyBenefits@dhw.idaho.gov. You can also visit idalink.idaho.gov.

I hope you have a safe and healthy weekend! 

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

In response to the pressing need for suitable housing for foster children, a new placement is set to open in Payette in the coming months and offer a lifeline to kids who were previously placed in short-term rental accommodations.

During the past couple of years child welfare staff with Family and Community Services (FACS) faced difficulties finding suitable placements for children entering foster care. We initially turned to hotel rooms, but the inadequacy of such spaces for children became apparent and led to the innovative idea of using short-term rentals.

As the number of children in need continued to grow, program staff found themselves managing six separate short-term rentals. Recognizing the inefficiency and lack of cost-effectiveness, the program explored creation of a centralized placement that would provide a more organized and licensed space.

The placement will provide housing for children that the program is unable to place quickly with foster parents, either because they are older children or because they have complex needs. One of the first and most important goals when children enter our care is to find them appropriate housing, but that can be difficult when the need arises during evening hours or the children’s needs are beyond what most foster parents are able to handle.

FACS is in the process of securing a vacant assisted living facility, which will be more suitable for meeting children’s needs. It will house up to 12 children in a more structured and cost-effective manner than housing them in short-term rentals. This new placement is committed to assuring children have comprehensive services, including mental health, physical health, and education.

The best place for children to live is in a home with their nuclear or extended family. The child welfare program seeks to place children in homes with foster families when their original families are unable to care for them safely.

Foster families are needed in Idaho. Those interested in becoming foster parents or learning more about the program can call 2-1-1 to obtain an application. The program also welcomes treatment foster parents, who play a crucial role in providing enhanced support to children with complex needs.

Last year, FACS successfully reunited over 700 children with their families, and facilitated 260 adoptions. As of late November, there were 1,549 children in foster care in Idaho, emphasizing the ongoing need for foster families and placements like the new home in Payette.

The opening of the Payette placement represents a significant step toward addressing the challenges faced by the child welfare program, with the hope of positively impacting the lives of children in need.

Cameron Gilliland is the administrator of the Division of Family and Community Services. He has worked for the department since 1996 in various capacities and was promoted to administrator in August 2021. He has been trained as a clinical social worker and has overseen policy for the Child Welfare Program and managed several developmental disability programs in the department.

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov.

Working at the Department of Health and Welfare (DHW) has been the highest honor of my career, and it’s also been the most challenging job I’ve ever had. That’s in part due to the dynamic range of daily tasks that come up. With eight divisions and 3,000 staff, we maintain countless systems to foster accountability and plan for the future, but almost every week at DHW is a reminder that you can’t plan for everything.  Staying nimble is part of the job.

It is in these times when we face unforeseen obstacles that we often discover profound lessons that shape our resilience and character. Over the past five years, the Department of Health and Welfare has faced a diverse range of challenges, prompting our staff to adjust, reprioritize, and forge ahead. In reflecting on the turbulent times, several invaluable lessons emerge.

• First and foremost, crisis underscores the importance of adaptability. The ability to pivot, adjust, and find innovative solutions is an invaluable skill in times of upheaval.
• Adapting to rapidly changing circumstances allows us to weather storms and emerge stronger on the other side.
• The resilience cultivated through adaptability helps us understand that even during challenging times, there is always room for growth.
• Crisis highlights the power of community and compassion. Whether on a global scale or within local communities, the outpouring of support and empathy in times of crisis is a testament to the strength found in togetherness. 
• The more extensive the crisis, the more collaboration needed by stakeholders to mitigate and respond.  By collaboratively working together, we can reach unforeseen heights beyond our individual reach.
• Last, and importantly, every emergency is an opportunity to be better prepared the next time unforeseen circumstances unfold. While it may be impossible to predict the exact nature of the next day’s or week’s work, having robust systems in place to respond efficiently and effectively is crucial.

In times of crisis, the value of community and interconnectedness becomes evident. The realization that we are all interconnected in the intricate web of life underscores the importance of fostering relationships, supporting one another, and cultivating a sense of shared responsibility.

I sincerely hope we won’t have to weather another child welfare emergency, pandemic, or recession, but by reflecting on the lessons we’ve learned, I know DHW will be better prepared if those circumstances come to pass.

Through adaptability, community, and preparedness, we can not only endure the challenges to come but also emerge wiser, stronger, and more compassionate.

Last month the Great American Smokeout served as a reminder for people who smoke to make a plan to quit for a healthier future. But quitting smoking is possible any time, and it’s one of the best choices a person can make to improve their health and protect their loved ones from cancer-causing chemicals.

Tobacco use remains the leading preventable cause of death in the US, accounting for about one in five deaths each year. While cigarette smoking rates have continued to decline in recent years due in part to the success of smoking cessation efforts, according to the Centers for Disease Control and Prevention (CDC), more than 28 million U.S. adults currently smoked cigarettes in 2021.

Project Filter supports Idahoans on their quit journeys

Project Filter is a state health program that supports people who want to quit smoking, vaping, or chewing. The program’s motto, “You decide when, and we will show you how,” shows that the program emphasizes methods and techniques without pressure.

The program also coordinates with policymakers, community organizations, and schools to help prevent people from using tobacco products. This is because if you never start, you never have to quit.

Quitting tobacco or vaping is hard. It takes most people multiple attempts to stay tobacco free. Many people have an easier time quitting with support from loved ones and free resources from Project Filter.

According to former smokers, calling The Idaho Quitline is one of the best steps a person can take to successfully quit. In fact, people who call are seven times more likely to quit using tobacco. The Quitline can be reached 24 hours a day, seven days a week by calling 1-800-QUIT-NOW.

Quitline coaches are encouraging and well-trained, and they know quitting is a personal journey. Coaches will help callers tailor their quit plans to their individual needs and can also help people find quit medications in the form of patches, gum, and lozenges, which can be shipped directly to people’s homes free of charge.

Finally, the Quitline serves a wide array of Idahoans and has unique programs tailored for people who are pregnant, living with mental illness, or are Native American. The Idaho Quitline also has coaches who speak Spanish and coaches who work with translator to support people who speak any other language.

Project Filter provides support for teens and their parents

My Life, My Quit is a free and confidential coaching program specifically designed for teens and young adults. The program helps teens and young adults quit vaping or smoking, and the sessions can be done through text messages, chat, or phone calls.

Teens can sign up on www.mylifemyquit.com, which also has resources for parents.

More information:

• For free support to quit smoking, vaping, or chewing, call 1-800-QUIT-NOW or visit http://www.ProjectFilter.org to learn more.
• For teen-specific resources, look up www.mylifemyquit.com.
• Follow Project Filter on Instagram or Facebook: @projectfilter.

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

For the rest of 2023 I plan to use my weekly blog to reflect upon some of the Department of Health and Welfare’s (DHW’s) accomplishments during my five-year tenure as director.

To be sure, these accomplishments are not my own, but have been planned, deliberated, an

d carried out by many DHW employees—often in collaboration with valuable community partners.

This week, I’m focusing on the incredible work being done to expand and connect Idaho’s behavioral health system.

One of the many hats I’ve worn as director at DHW is that of co-chair of the Idaho Behavioral Health Council, which was established by all three branches of government via proclamation from the Idaho Supreme Court, a concurrent resolution from the Legislature, and by Gov. Brad Little’s July 29, 2020 executive order.

The council is unique because it includes members from all three branches of government: executive, judicial, and legislative. It also includes local government and citizens.

Since its inception, the IBHC’s 13 members have worked with local governments, service providers, community partners, and people who use behavioral health services and their families to identify a list of recommendations to move Idaho closer to making behavioral health care more consistently available to all Idahoans.

This is important because behavioral health issues affect many aspects of life in Idaho, including Idaho’s corrections system, judicial system, hospitals, and communities.

The council’s vision is that adults, children, and their families who live with mental illness and addiction receive the behavioral healthcare services they need, when they need them.

There’s still a lot of work to do to fulfill that vision, but it’s gradually becoming reality. Here are some notable milestones:

• In July of 2022, the Division of Behavioral Health (DBH) at DHW successfully implemented the Idaho 988 Suicide and Crisis Lifeline. Now the Idaho Crisis and Suicide Hotline (ICSH) answers calls and texts placed to 988 in Idaho. From July 2022 to June 2023, the ICSH answered 12,657 calls that were made via 988.
• DBH worked to establish four new youth crisis centers in Idaho Falls, Twin Falls, Boise, and Nampa. Youth often first enter the continuum of care in Idaho after a crisis becomes an emergency. They end up committing a crime or being taken to a hospital. The new Youth Behavioral Health Community Crisis Centers (YBHCCCs) will help ensure youth in crisis receive an appropriate level of crisis treatment, rather than being hospitalized or incarcerated.
• Idaho now has five Certified Community Behavioral Health Clinics (CCBHCs), which are clinics that provide whole-person care under one roof. CCBHCs create access to an array of services, stabilize people in crisis, and provide necessary treatment for people with complex mental illnesses and substance use disorders. They also ensure an approach to healthcare that emphasizes recovery, wellness, trauma-informed care, and the integration of physical and behavioral health. CCBHCs must provide nine core services, either directly or through formal partnerships.
• There is and needs to be a strong focus on recovery in any behavioral health system of care. DBH created the first-ever Recovery Coach Academy (RCA) in Idaho.  The RCA provides training and mentoring for recovery coaches who help adults with substance use disorder issues. More than 89 coaches, from all over Idaho, have completed training through the RCA, and 50 more have started the process. Additionally, we have identified sustainable funding for Idaho’s nine Recovery Community Centers.
• The division is also working with partners across the state to open more than 85 new psychiatric residential treatment facility (PRTF) beds in three locations across Idaho. Historically, youth needing PRTF level of care had to go out of state. These Idaho operated facilities will prioritize Idaho youth and will allow us to bring Idaho’s youth home.

These accomplishments are due to hundreds of people who work to make a difference for Idahoans, and I’m proud to have played a role. I’m also confident that the many important employees working behind the scenes at DBH, our partners and stakeholders will continue to do this good work to get Idahoans the mental health care they need, when they need it.

I hope you have a safe and healthy weekend!

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

The Division of Behavioral Health at the Department of Health and Welfare recently refreshed its media campaign to reach Idahoans facing substance use disorders. The Lose Focus campaign uses evocative, out-of-focus images and reflections in mirrors, and aims to stir emotions that propel people toward decisive action. While recognizing the need for help may be a gradual process, the campaign emphasizes that the journey to healing can commence immediately.

“Substance use, over time, may make you lose focus of how you see yourself,” states the campaign’s DHW webpage. “Drugs or alcohol create the potential to blur the self-image you see reflected in the mirror.”

Substance use disorders affect thousands of Americans, irrespective of socioeconomic background, social standing, race, or age. Individuals may find their lives becoming unmanageable but may hesitate to acknowledge their struggle or be uncertain about where to seek help.

According to the Substance Abuse and Mental Health Services Administration, 48.7 million Americans over the age of 12 struggled with a substance use disorder in 2022. That constituted 17.3% of the population. The Lose Focus ad campaign is specifically tailored to individual people and families actively seeking assistance.

The Lose Focus campaign will run through June 2024. It features television ads in both English and Spanish, alongside banner ads on websites, social media posts, billboards, and radio segments. Striking campaign images will be transformed into posters, displayed in behavioral health offices and crisis centers statewide. The initiative encourages Idahoans who resonate with the Lose Focus message to call the 2-1-1 Idaho CareLine for support.

The CareLine's comprehensive database includes programs offering free or low-cost health and human services. Idahoans can easily connect with a 2-1-1 community resource specialist by dialing 2-1-1 or 800-926-2588, or by texting 898211, Monday through Friday, 8 a.m. to 6 p.m. MST.

For additional details, please visit the Lose Focus webpage: www.healthandwelfare.idaho.gov/LoseFocus.

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

Research shows that taking a few minutes to recognize and express gratitude each day does wonders to improve mood and mindset.

Our minds are wired to watch out for risks and to identify potential problems. This likely comes from our ancient ancestors for whom watching for bears and wolves was much more important than remembering where beautiful flowers were blooming. Taking a few minutes to remember the things that we’re grateful for—not just on Thanksgiving but every day—can dramatically change our mindset, lift our mood, and balance out negative things that all of us experience and feel each day.

There are multiple leadership meetings that DHW holds each week, and in all of these meetings we use the first five or so minutes to share good things that have happened for us either personally or professionally, as individuals or as a group.

During the course of our leadership meetings last week, we heard about people’s Thanksgiving plans and visits with family or friends.

More specific to DHW’s work, we also received word that State Hospital West in Nampa has been accredited after a lengthy and thorough vetting process by the Joint Commission. State Hospital West provides inpatient psychiatric treatment to Idaho’s youth ages 10 to 17, and accreditation means the hospital has demonstrated a commitment to continuous improvement in patient care.

We also heard news this week that State Hospital South in Blackfoot is fully staffed for nurses for the first time in months. Both of these were great news for DHW’s senior leaders, but they’re great for Idahoans as well.

Each week, I’m inspired by the many good things that happen here at DHW and in people’s personal lives.

For me, as I think about this season of Thanksgiving and reflect on my five years of service at DHW, the things I’m most grateful for are my family, friends, and the amazing staff at DHW. I’m continually amazed by the level of commitment DHW’s staff bring to work to help their fellow Idahoans, and the compassionate ways they go about doing their important work.

I’ve had the chance to watch firsthand the direct and often immediate positive impact DHW’s staff has on individuals and families. I’ve often said—and firmly believe—that the staff at DHW are the ones who do the real work. My job is to do everything I can to support them so they can be successful in strengthening the health, safety and independence of Idahoans.

As we do during our leadership meetings at DHW, I’d encourage Idahoans to practice gratitude as part of a daily or weekly routine. Simply think about the things you’re grateful for and share them with a friend, family member, coworker, or neighbor.

I think you’ll be surprised by the impact it’ll have.

I hope you had a wonderful Thanksgiving and that you have a safe and healthy week! 

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov. 

November is National Alzheimer’s Disease Awareness Month and an opportunity to reflect on ways we can support those with an Alzheimer’s disease diagnosis, and measures we can take to reduce the chances of developing Alzheimer’s ourselves.

Many people we’ve spoken with say that once they mention they have Alzheimer’s disease, people respond with an expression of pity. People want to help, but often distance themselves from the person who has the disease, as well as from the family member giving them care, leaving both feeling isolated.

We know that this type of distancing is not done maliciously, but out of discomfort and fear of the unknown and fear of being a burden to a challenging disease process. The irony is that the person with Alzheimer’s—their friend or family member who they’ve known for years or decades—has already had Alzheimer’s for five to 20 years ahead of their recent diagnosis.

Alzheimer’s disease is broken into five phases, they are:

Preclinical: No symptoms but possible biological changes in the brain.

Mild cognitive impairment: Very mild symptoms that may not interfere with everyday activities.

Mild dementia: Symptoms interfere with some everyday activities.

Moderate dementia: Symptoms interfere with many everyday activities.

Severe dementia: Symptoms interfere with most everyday activities.

Why are these stages important to know? In the U.S. an estimated 60% or more of Americans go undiagnosed. Many will receive a diagnosis when they’re in the last two phases of the disease, and generally when they’re in crisis.

There are many reasons why people choose not to get checked or diagnosed: the overall negative stigma around the disease, lack of knowledge and understanding about the signs and symptoms, absence of testing or resources in the areas they live, and the sense of worry about the potential outcome of a diagnosis.

The stigma around Alzheimer's disease has always been prevalent as many people see this type of diagnosis as being only for elderly, those who are sick, or as the absolute worst thing that can happen to a person.

According to an article from the National Institute of Health, “The perception is that (Alzheimer’s disease) patients have little to no quality of life, due to their disease, which may lead to a loss of independence and dignity.” Other common stereotypes include being burdensome, incompetence, and not being able to contribute to society. 

Society's view on an Alzheimer's diagnosis is a harmful one, due to many people not understanding the cause or progression of the disease, but it is not just the common population that holds this view. Many people within the healthcare field also perceive the disease this way. A survey of primary care providers reported that “Nearly 2 in 5 (39%) of physicians report that they are ‘never’ or only ‘sometimes comfortable’ making a diagnosis of Alzheimer's or other dementia.”

It’s not all negative, though. There are many resources and opportunities that can help people with an Alzheimer’s diagnosis improve their quality of life. A few examples of things they and their loved ones can do include, staying connected and communicating regularly, maintaining a healthy diet, staying active and exercising regularly, staying social, and living in a safe and calm environment. 

Resources:

• November is National Alzheimer’s Disease Awareness Month. Read the proclamation.
• DHW resources for Alzheimer’s disease and related dementias.

Tiffany Robb is health program manager for the Alzheimer’s Disease and Related Dementias Program in the Division of Public Health at DHW. A self-described compassionate extrovert, she’s had a diverse career that’s included personal training, business ownership and management, teaching, research, and project management. Tiffany finds working on brain health, Alzheimer’s, and dementia an honor and a tribute to family members who have been impacted by dementia.

Brooke Zander is an intern working with the Alzheimer’s Disease and Related Dementias program in the Division of Public Health at DHW. She’ a student at Boise State University working on a Bachelor of Health Science degree, with expected graduation in December 2023.

The Idaho Department of Health and Welfare is dedicated to strengthening Idahoans' health, safety, and independence. Learn more at healthandwelfare.idaho.gov.