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October 24, 2018

Sandra Day O'Connor, longtime Alzheimer's advocate, has been diagnosed with dementia

Daily Briefing

    Read Advisory Board's take: 5 ways to improve care for dementia patients

    Sandra Day O'Connor, the first woman to serve on the Supreme Court, on Tuesday in a letter to Americans announced that she will be withdrawing from public life, following her diagnosis "some time ago" of dementia.

    O'Connor wants to 'be open' as disease progresses

    O'Connor, 88, in the letter wrote, "Some time ago, doctors diagnosed me with the beginning stages of dementia, probably Alzheimer's disease." She continued, "As this condition has progressed, I am no longer able to participate in public life."

    O'Connor wrote that she penned the letter so she could "be open about these changes, and while [she is] still able, share some personal thoughts." O'Connor wrote that she feels "fortunate … to be an American and to have been presented with the remarkable opportunities available to the citizens of our country." She added that when she retired from the Supreme Court 12 years ago, she made a commitment to use her remaining years "to advance civic learning and engagement." However, O'Connor wrote that she could "no longer help lead this cause, due to [her] physical condition."

    Jay O'Connor, Sandra Day O'Connor's son, said his mother's "memory was starting to be more challenging, so the time came to dial back her public life."

    'A towering figure'

    O'Connor was nominated to the Supreme Court by former President Ronald Reagan in 1981. O'Connor was a swing vote on cases regarding a number of social issues and was at the center of some major court decisions, including decisions related to abortion rights, health insurance, and accessibility for individuals with disabilities, according to the American Civil Liberties Union.

    O'Connor retired in 2006, in part to take care of her husband, John O'Connor, who had Alzheimer's. He died in 2009.

    After her retirement, O'Connor became an advocate for Alzheimer's disease research and, in 2009, she helped launch iCivics, a website that provides teachers with materials to educate students about civics.

    Chief Justice John Roberts in a statement called O'Connor "a towering figure in the history of the United States and indeed the world." He said he was "saddened to learn" of her diagnosis, but added that "no illness or condition can take away the inspiration she provides for those who will follow the many paths she has blazed."

    The Alzheimer's Association in a statement said, "In all aspects of her life … O'Connor has been a transparent leader, and being forthcoming about her diagnosis is another demonstration of this." The group added, "We commend … O'Connor for bravely sharing her diagnosis and increasing awareness about this devastating disease" (de Vogue/Stracqualursi, CNN, 10/23; Barnes, Washington Post, 10/23; Williams/Fieldstadt, NBC News, 10/23; Wheeler, The Hill, 10/23; Haag, New York Times, 10/23; ACLU website, accessed 10/24).

    Advisory Board's take

    Anna Yakovenko, Practice Manager, and Emily Heuser, Consultant, Market Innovation Center 

    Sandra Day O'Connor's sad news about her dementia puts her in a group with many high-profile figures who have reported developing the devastating condition. Her situation is also expected to become more common. As life expectancy increases and the baby boomer generation reaches Medicare age, the number of Americans diagnosed with dementia—particularly Alzheimer's disease—is projected to skyrocket. Currently, 5.7 million Americans have Alzheimer's—a figure expected to rise to 14 million by 2050.

    Providers need to make sure they are prepared to address this rise and meet the unique needs of patients with dementia. Here are 5 ways they can begin to prepare:

    1. Educating the community about the condition

      Providers can play a valuable role in the community by providing patients and their caregivers with information about early detection of dementia. This education is pivotal for encouraging early detection and decreasing the cost burden of dementia care—as a patient with mild symptoms costs $18,400 to treat annually, whereas a patient with severe symptoms costs up to $36,132 on average.

      Our research on baby boomers indicates that they are highly apprehensive about developing the condition—in one survey 87% of boomers said they were 'extremely' or 'very concerned' about staying mentally sharp in the future—and are highly receptive to education about early detection. Therefore, this education is not only appreciated, but can also brand your hospital as a go-to dementia provider.

    2. Strengthening staff skills

      Dementia patients require unique skills among care staff, who can best excel in providing high-level care when they fully understand the condition and its progression. Your organization can encourage staff to exceed state requirements for dementia training by becoming a Certified Dementia Practitioner or taking other Alzheimer's and dementia trainings offered through the National Council of Certified Dementia Practitioners

    3. Creating cross-service line dementia care teams

      Cross-service line care teams can help to improve care coordination for dementia patients and make their hospital experience less overwhelming and stressful. For instance, at New York-Presbyterian Hospital, dementia patients receive care from a multidisciplinary team of healthcare professionals including neurologists, neuropsychologists, social workers, nurse practitioners, and rehabilitation specialists. In addition to screening and treatment services, this team provides neuropsychological assessments, patient and caregiver education, and assistance in managing patient care.

    4. Promoting treatment in outpatient settings

      Work with PCPs to encourage dementia patients to seek care at outpatient centers. Although patients can still feel disoriented and confused in outpatient clinics, these sites of care tend to be less overwhelming and upsetting to dementia patients than inpatient settings.

      When possible, you can structure consultations or tests to be conducted in outpatient facilities before inpatient admission. Learn more about outpatient geriatric assessment centers and geriatric emergency departments if you're interested in alternative options for better accommodating dementia patients.

    5. Demystifying the discharge process

      Create easily-understandable, printed discharge materials about planning for future care for dementia patients and their caregivers. A JAMA study found that even elderly patients without dementia struggle to understand normal discharge directions. Materials written at an accessible reading level and accompanied by pictures can help patients and their caregivers understand post-treatment procedures and how to prevent complications.

    To learn the best practices in creating a dementia program, download our research report on Building a Financially Sustainable Alzheimer's Disease & Memory Disorders Program. Then, for a quick overview about developing your geriatrics program, download our Geriatrics Cheat Sheet.

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