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Pennsylvania’s Dementia Care Is A ‘Public Health Emergency,’ But Resources Are Lacking

An old woman uses a walker in a nursing home hallway.
Julie Bennett
/
AP

On today’s program: The state has already created guidance for expanding dementia care in the commonwealth, but despite a growing, aging population, few recommendations have been implemented; we look at the possible effects of a bill meant to reduce gun violence due to mental health crises, which has been introduced to the state legislature; and a reflection from Colonel Paul Evanko, the commissioner of the State Police when Flight 93 went down in Somerset County on Sept. 11, 2001. 

The need for quality Alzheimer’s care is on the rise and expected to grow further in the coming years

(0:00 - 4:57)

Despite a plan commissioned in 2013 by then-Gov. Tom Corbett to prepare for the growing dementia crisis in Pennsylvania, the state is still struggling toserve it’s aging residents.

“When we checked with state officials to see what progress had been made thus far, seven years later, we were surprised to find a minimal amount of completion on many of these provisions,” says Colin Deppen with SpotlightPA. He and Juliette Rihl from PublicSource published an investigation into this issue.

Deppen says the previously commissioned plan called for deeper partnerships with private entities, and it successfully established an annual forum on aging.

There are approximately 280,000 residents over the age of 84 living with Alzheimer's disease in the commonwealth, and that number is expected to grow by 10,000 a year over the next four years.

“The Department of Human Services said something like 85% of nursing facility services are covered by Medicaid in Pennsylvania,” says Deppen. Medicare and private insurers pay for limited services, but for many middle-class earners, it’s not enough.

The lack of present resources can, in part, be attributed to the ongoing COVID-19 pandemic, but the crisis of aging Pennsylvanians in need of dementia care had been brewing before 2020.

“We’ve been told there is an unwillingness to confront this issue, sort of a human reluctance to talk about aging, morbidity, things of that nature,” says Deppen.

The state also has a 2020-2024 State Plan on Aging, which is required to receive federal funding for aging services, but the newer plan has less intense requirements than the 2013 plan.

Pennsylvania legislature to consider Extreme Risk Protection Orders to reduce gun violence during mental health crises(5:01 - 14:10) 

When someone is in a mental health crisis, a firearm can pose a significant risk, potentially increasing the threat of suicide or other gun violence. In some states, family members and loved ones have a mechanism to temporarily disarm those in crisis, called Extreme Risk Protection Orders (ERPO).

One bill that would create such a rule has been proposed by Senator Wayne Fontana of Allegheny County and is in the Senate Judiciary committee. Another measure in the House is expected to be proposed by Republican Rep. Todd Stephens of Montgomery County.

“In other states that have this law, there are 19 states and the District of Columbia, we see that there is a pretty significant decline in suicides, between a 13% and 18% decline in suicides,” says Josh Fleitman, Western Pennsylvania manager for CeaseFirePA.

“Some of the areas of the state that are perhaps most concerned about the second amendment, primarily rural areas, we know they also have some of the highest rates of suicide, and so there’s an opportunity there to really connect a direct problem to a direct solution,” says Fleitman.

Fleitman says although some worry the law could be used to retaliate against someone, there are provisions that make such action illegal.

Dr. Jack Rozel, the medical director of resolve Crisis Services at UPMC Western Psychiatric Hospital says what is even more ideal in situations of crisis is if someone voluntarily relinquishes any firearms to a trusted family member or friend. But without that voluntary action, he supports a measure like Extreme Risk Protection Orders.

“You can be anti-gunshot wound, you can be anti-gun violence without being anti-2A [Second Amendment],” says Rozel. “Good people with guns get depressed and go through crises too.”

Former State Police Commissioner Colonel Paul Evanko on responding to the events of September 11

(14:14 - 22:30)

More than 600 troopers and officers with the State Police assisted with the investigation and recovery efforts when United 93 went down in Stonycreek Township, in the days and weeks after the terrorist attacks of September 11, 2001.

The man who led the agency was Colonel Paul Evanko, who served two terms as commissioner under then-Gov. Tom Ridge.

Evanko’s personal notes detailing the state police response to 9/11 are now in the collection of the Pennsylvania State Archives and will be on display at the State Museum of Pennsylvania, starting September 9th.

Colonel Evanko spoke to WITF's Tim Lambert about that day. WITF’s Sam Dunklau and Joe Ulrich produced this remembrance from that interview.

The Confluence, where the news comes together, is 90.5 WESA’s daily news program. Tune in Monday to Thursday at 9 a.m. and 7:30 p.m. to hear newsmakers and innovators take an in-depth look at stories important to the Pittsburgh region. Find more episodes of The Confluence here or wherever you get your podcasts. 

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