Marilyn Penn: Dementia in Manhattan

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Recently, an old friend was moved into a dementia unit on the upper west side.  It appeared to be as cheerful, well-run and upbeat as one could hope, with art-filled corridors and photos of patients’ families outside their rooms.  Within a few weeks of his move, families were suddenly informed that the unit was closing and patients requiring this special security and care would have to be evicted.  Although the facility encompassed only 28 beds, the panic and distress this notice caused made me curious about the availability of residential dementia units in NYC and I was shocked by what I discovered.

Going by the population numbers of the 2010 census, there are approximately 320,000 seniors who live in Manhattan.  The Alzheimer’s Association estimates that 1 in 9 people over 65 has dementia, leaving us with approximately 34,450 Manhattan residents who are afflicted with this disease.  Out of these, a significant number will eventually require custodial care outside the home, preferably in Manhattan so that elderly spouses (and family and friends) would be able to visit without driving or the expense of car service.  Yet, in all of our medically sophisticated borough, there are only a handful of residential  facilities which accept patients with dementia – under 200 beds in all.  Three of the places that I contacted admitted that the wait for admission could be years and that priority was given to the nursing home’s own residents who worsen into dementia as they age.  Only one facility in Manhattan is solely devoted to “memory care” and that has availability for only 69 patients.

There is currently no cure for Alzheimer’s disease or related dementias and as the percentage of people living longer increases, so will the numbers of afflicted seniors.  There are no urgent calls to action from our mayor or governor, both of whom have expressed great concern over the plight of the homeless, the majority of whom are housed in shelters.  Approximately 1,000 do not avail themselves of shelters and sleep on the city streets – a fraction of 34,500 seniors with dementia – many of whom are now or soon will be in desperate need of supervised housing.  The government indifference to this problem is highlighted even more by its concern for the needs of the transgender community – estimated at 700,000 in the entire United States or 0.3% of our national population.  Our governor recently issued an executive action prohibiting discrimination against this group in housing, employment, hospitals, schools, public accommodations and all financial services.  Though no one questions the need for legal protections for all minorities, one wonders how this tiny group of people was able to garner the governor’s attention while the immeasurably larger group of afflicted seniors has not.  One can also question the effectiveness of AARP, the Alzheimer’s Association and medical personnel, social workers and support groups directly involved with Alzheimer patients and their families.  There is an acute need for more residential facilities for this population of our elderly, most of whom worked hard, paid their taxes, paid their children’s tuitions at school and asked for no government handouts.  Their sad inability to lobby for their own cause is all the more reason for our united activism in their behalf.

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