Building A Better Future For Alzheimer's Care

Real change in Alzheimer's care starts with honesty about what isn't working and hope for what's possible.

Four years ago, when Sherry's mother passed away, it became clear that her father had memory problems. Her mother had managed to keep things looking normal. When she was gone, the picture changed. Her father insisted he was fine, but there was fear. He refused to be evaluated for a long time. Eventually, he was diagnosed with Alzheimer's. After that, he quickly withdrew.

Sherry, in her early sixties, got in the habit of calling on him daily. But eventually that wasn't enough. She needed to move in. At first, she kept working. As his needs grew, it became obvious he could not be left alone. Paid help would have cost more than she earned. She retired to take care of him.

Four years later, her father has advanced dementia. He qualifies for nursing home care through Medicaid because he is indigent. The savings he built over a lifetime are gone. Both have suffered, in their different ways.

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Sherry's story is common. A parent's memory fades. There's resistance to seeing a doctor. After diagnosis, things fall apart, one step at a time. Each change, looking back, seems obvious. But it shouldn't be this way.

This July, I want to step back from the day-to-day of Alzheimer's care and ask a bigger question. What can we do better?

Fear Is Its Own Disease

Everything we hear about Alzheimer's creates fear. We listen to stories and decide it's the worst disease there is. We become afraid of it.

Fear causes real damage. Diagnosis and treatment get delayed, sometimes for far too long. Finances become a mess. The person becomes an easy target for scams. Families avoid the hard conversations about what each person feels, fears, and hopes for.

There's a deeper harm too. Once a diagnosis can no longer be denied, the person often feels like a sentence has been handed down. You are now what the world told you to fear. Friends visit less. When they do, it's not comfortable. Fear has led to stigma, and the person can sense it.

Here's what I want people to know: fear makes Alzheimer's worse than the disease itself. At any given time, about half of the people with Alzheimer's are in the mild stage. Most never reach severe. Even with this disease, people still live, love, and experience joy.

A Disease-Care System, Not a Healthcare System

We think we have a healthcare system. In reality, we have a disease-care system.

The disease-care system asks one question: what's the matter? Tests confirm a diagnosis. Medications follow. When things don't improve, you get referred deeper into the system.

I'd ask a different question: what matters? What matters to this person, and to the family caring for them? From that question, the real concerns surface. Who can I call right away when something happens? Where can I get support? Are there good programs that can help?

For Alzheimer's, this difference is everything. Visits often end with words like "probably" or "we'll keep an eye on it." A pamphlet gets handed over. Then the system has done its job, and the family is on its own. Compare that to how we treat diabetes or heart disease, where the targets are clear, and the next step is obvious. Alzheimer's deserves the same clarity.

Care That Isn't Coordinated Isn't Care

One reason care doesn't improve is that it's fragmented. A doctor adjusts medications. A specialist recommends therapy. A social worker offers resources. But no one is talking to each other, and the family is left to bridge the gap alone.

Medicare's new GUIDE program was built to address exactly this. It puts an expert team, continuity, and 24/7 support around a family instead of scattering care across strangers. Programs like this work because they understand something simple: Alzheimer's care cannot be fragmented. It needs people who know your situation and can actually help.

Prevention Deserves More Attention

The search for a cure must continue, and it will. But nearly half of dementia cases are preventable through changes we already understand. That's worth repeating. Almost half.

Managing blood pressure, treating diabetes, avoiding obesity — these aren't just good for the heart. They lower the risk of Alzheimer's too. When researchers adjust for age, the rate of dementia among older Americans is actually falling. Good treatment of chronic disease works. We used to think a lower risk of stroke was out of our hands. Now we know better. It's time we said the same about Alzheimer's.

Who Pays

Any honest conversation about doing better has to include this question. The lifetime cost of caring for one person with Alzheimer's runs close to $400,000. Roughly seventy percent of that falls on families. Out-of-pocket costs for dementia run about double those for heart disease or cancer.

Most families fall into a gap. They earn too much for Medicaid and don't have nearly enough saved for years of long-term care. One in five spends through a lifetime of savings and ends up on Medicaid anyway, which is exactly what happened to Sherry's father. This isn't just a family problem. When a caregiver leaves the workforce, the whole economy feels it.

The GOLD Approach to What We Can Do Better

I keep coming back to the same framework because it still holds true here.

Gradual. Change doesn't happen all at once. Better Alzheimer's care will come from steady, patient progress, not a single fix.

Open. Families, doctors, and systems all do better when they speak honestly rather than protect appearances. Fear thrives on silence.

Loving. Every policy and program should ultimately be judged by whether it makes life better for the person and the caregiver standing beside them.

Dignified. Whatever changes come, they must preserve the person's sense of self, not just manage their disease.

A Way of Being

What we can do better isn't only about fear, or healthcare, or financing. Step back, and it's really a way of being. Until there's a cure, Alzheimer's remains a heavy burden. For now, we still need to make every day a normal day. One with challenges, but still with love. One with mistakes, but still dignity.

Fear, disease-care, fragmented systems, unaffordable costs — these aren't separate problems. They're part of one larger question. How do we, as individuals and as a society, care for each other?

Getting Older with Love and Dignity isn't just the title of my book. It's a way of being. Each of us is a life. We embrace each other, care for each other, and feel whole despite injury.

That's how we do better.

Warmest Aloha,

Dr. Warren Wong

PS: I say it over and over again: There's no one more important than the caregiver in the daily life of a frail person.