Assembly Democratic Bill Package to Boost Care for Alzheimer’s Disease Advanced by Health Committee

An Assembly panel on Thursday approved a two-bill package sponsored by Assembly Democrats Carmelo G. Garcia, Valerie Vainieri Huttle, Joe Danielsen, Wayne DeAngelo, Jamel Holley, Daniel Benson, Joseph Lagana, Adam Taliaferro, and Angelica Jimenez to boost care for patients with Alzheimer's disease and get a better handle on how many people succumb to the illness in New Jersey.

The first bill (A-4331), sponsored by Garcia, Vainieri Huttle, Danielsen, DeAngelo, Holley and Benson, would amend current law to permit standards and curricula for homemaker-home health aide education and training to include comprehensive training in the specialized care of a patient with Alzheimer's disease and related disorders. A list of individuals who have completed this training program would be available in the New Jersey Board of Nursing's registry of persons who have completed a homemaker-home health aide training program.

 

An Assembly panel on Thursday approved a two-bill package sponsored by Assembly Democrats Carmelo G. Garcia, Valerie Vainieri Huttle, Joe Danielsen, Wayne DeAngelo, Jamel Holley, Daniel Benson, Joseph Lagana, Adam Taliaferro, and Angelica Jimenez to boost care for patients with Alzheimer's disease and get a better handle on how many people succumb to the illness in New Jersey.

The first bill (A-4331), sponsored by Garcia, Vainieri Huttle, Danielsen, DeAngelo, Holley and Benson, would amend current law to permit standards and curricula for homemaker-home health aide education and training to include comprehensive training in the specialized care of a patient with Alzheimer's disease and related disorders. A list of individuals who have completed this training program would be available in the New Jersey Board of Nursing's registry of persons who have completed a homemaker-home health aide training program.

"Unfortunately, like the national Alzheimer's Association often says, everyone with a brain is at risk for Alzheimer's," said Garcia (D-Hudson). "That's why we need to boost standards in this state to ensure this vulnerable population is well taken care of."

The bill defines "Alzheimer's disease and related disorders" as forms of dementia characterized by a general loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning.

"Since home health aides spend many hours a day with patients with Alzheimer's disease and related disorders, it's important that these aides are well-trained to provide appropriate, competent, and compassionate care," said Vainieri Huttle (D-Bergen).

Current law requires the New Jersey Board of Nursing to prescribe standards and curricula for homemaker-home health aide training, which must be completed in order to work as one in this state. The law, however, does not specify training in the care of patients with Alzheimer's disease and related disorders.

"Sadly, Alzheimer's is the only cause of death, out of the top 10 in this country, that cannot be cured, slowed or prevented," said Danielsen (D-Middlesex/Somerset). "Until it can, we need to improve care and treatment for it through methods such as this."

The training program established under the bill is similar to the one required under current law for direct-care staff in long-term care facilities, and would include the causes and progression of Alzheimer's disease and related disorders, and methods to deal with the specific problems encountered in the care of such a patient.

"The care needed to provide for someone with these types of illnesses requires an extreme level of diligence," said DeAngelo (D-Mercer/Middlesex). "Through increased training, hopefully we can enhance this care and improve patients' quality of life."

Specifically, the methods would include: 1) communicating with patients with Alzheimer's disease and related disorders; 2) psychological, social, and physical needs of patients with Alzheimer's disease and related disorders; and 3) safety measures which need to be taken for a patient with Alzheimer's disease and related disorders.

"Alzheimer's disease and related disorders present a very unique set of challenges for both the patient and those who care for them," said Holley (D-Union). "Enhanced training will better prepare home aides to handle these day-to-day challenges."

Under the bill, a person who applies for certification as a homemaker-home health aide on or after the effective date of the bill would have the option to complete Alzheimer's training as a part of the certification process. Persons who already are certified as homemaker-home health aides may complete the training in receiving their first recertification after the bill's effective date.

"Few people haven't been touched by someone in their lives who has suffered from this illness," said Benson (D-Mercer/Middlesex). "Every family wants to know that they're loved one is receiving the best care possible and that's where more comprehensive training comes in."

The second bill (A-4188), sponsored by Garcia, Lagana, Taliaferro, Vainieri Huttle, Danielsen, Holley, Benson and Jimenez stipulates that Alzheimer's disease and related disorders may be listed as a secondary cause of death on a certification of death.

Such a designation may be listed, provided that: (1) the deceased person is diagnosed with Alzheimer's disease or a related disorder, and (2) it is determined, in accordance with currently accepted medical standards and with a reasonable degree of medical certainty, that Alzheimer's disease or a related disorder was a significant contributing cause of the person's death.

"Although data indicates that nearly 84,000 people died from Alzheimer's and related disorders in 2010, studies suggest that the true number of deaths attributable to these conditions may be greater than 500,000," said Lagana (D-Bergen/Passaic). "This discrepancy is due in part to the way deaths are recorded on death certificates. This bill aims to create a more accurate picture to aide medical professionals."

"It's important that we gain a more accurate picture of the number of deaths caused by Alzheimer's and related disorders because it can have a significant impact on the way these illnesses are treated, research is directed, and funding for all of these things is allocated," said Taliaferro (D-Cumberland/Gloucester/Salem).

"There is huge discrepancy between the number of deaths actually recorded from Alzheimer's and related disorders and the real number believed to be attributable to these illnesses," said Jimenez (D-Bergen/Hudson). "Given that it's the only major cause of death that can't be cured or prevented, we need to improve data in order to boost research."

Often, the primary cause of death will be identified as an acute condition such as pneumonia or heart failure. However, Alzheimer's disease and related disorders cause a decline in brain function that may lead to problems with feeding and swallowing, which can put the person at risk for poor nutrition, dehydration, and infection, and may significantly increase the risk of developing, and exacerbate the effects of, the acute condition that is ultimately listed as the primary cause of death on the person's death certificate.

Nothing in the bill would require Alzheimer's disease and related disorders to be listed as a secondary cause of death on a death certificate, and the bill provides that no person may be subject to criminal or civil liability or professional disciplinary action under Title 45 of the Revised Statutes for listing or failing to list Alzheimer's disease or a related disorder as a secondary cause of death on a certification of death.

Both bills were advanced by the Assembly Health and Senior Services Committee.