Alzheimer's Disease and Dementia Care

Alzheimer's disease is the most common form of dementia, accounting for up to 80% of all cases. The Alzheimer’s Association estimates over 6 million Americans 65 and older are currently living with Alzheimer's.

Amyloid-beta plaques in the brain begin to develop years to decades before symptoms of Alzheimer’s occur, and the rate of disease progression varies from person to person. According to the Alzheimer’s Association, life expectancy for a person with Alzheimer’s disease is usually 4 to 8 years after diagnosis, but some people may survive longer — even a decade or more. Death from Alzheimer’s is usually related to complications such as malnutrition, dehydration or infections such as pneumonia.

Alzheimer's disease is not a normal part of the aging process, but the risk for developing Alzheimer’s increases with age. Alzheimer's is characterized by memory loss, difficulty recognizing people, and problems with communication. Over time, the symptoms worsen, and people with Alzheimer's eventually will require extensive assistance with daily activities such as dressing, eating and bathing. Behavioral and psychological symptoms of dementia (BPSD) may be present, including apathy, agitation, hallucinations, delusions and motor behaviors such as pacing.

Currently, there is no cure for Alzheimer's. However, the U.S. Food and Drug Administration (FDA) has approved several medications that may slow the progression of symptoms and improve quality of life.

While antipsychotic medications have often been prescribed to treat BPSD, these medications are generally approved only for use when treating specific mental illnesses such as schizophrenia and bipolar disorder. All antipsychotics carry a black box warning from the FDA stating that they are associated with increased rates of stroke and death in older adults with dementia. In 2023, the FDA approved the use of the antipsychotic brexpiprazole to treat agitation related to Alzheimer’s disease. Despite this new indication for use, brexpiprazole still carries the black box warning. The physician must consider both risks and benefits before prescribing this medication, and non-pharmacological interventions should be considered the first line of treatment for BPSD.

Antipsychotics are only appropriate for use in older adults with dementia in a small number of situations, particularly when clinically necessary to treat targeted behaviors that are causing harm or significant distress to the person or others. In these situations, antipsychotics should be used at the lowest possible dose for the shortest time possible. The HHSC Appropriate Use of Psychotropic Medications page has more information about antipsychotic medications and alternatives to their use in people with dementia.

HHSC Training Opportunities

Alzheimer's Disease and Dementia Care Training Seminar

HHSC offers the Alzheimer's Disease and Dementia Care Seminar to help front-line staff and health care professionals provide appropriate, competent, and sensitive care and support to people with dementia. The eight-hour course uses a curriculum developed by the National Council of Certified Dementia Practitioners (NCCDP) and covers topics including:

  • Diagnosis
  • Environment
  • Activities
  • Communication
  • Intimacy and sexuality
  • Pain
  • Abuse and neglect
  • Nutrition
  • Feelings
  • Diversity and cultural competency
  • Spiritual care and end of life
  • Activities of daily living

Upon successful completion of the course, healthcare professionals and front-line staff will be eligible to apply for certification through NCCDP.

QMP offers this class in-person or virtually via Microsoft Teams. For in-person classes the minimum attendance is 10 people. To schedule the Alzheimer’s Disease and Dementia Care Seminar in your facility, complete this online request form or email the HHS Quality Monitoring Program (QMP).

Virtual Dementia Tour®

The Virtual Dementia Tour®, “Your Window into Their World®,” simulates the physical and mental challenges of dementia. This training allows caregivers to “experience” dementia for themselves through a tool that allows them to better understand the behaviors and needs of their residents. People who experience this sensory training move from sympathy to empathy and have a greater understanding of the realities of living with dementia.

This training is available across the state either through joint training opportunities or on-site at a nursing facility (NF). For more information or to request a Virtual Dementia Tour® in your facility, complete this online request form or email QMP.

Person-Centered Thinking Training

Person-Centered Thinking Training is an interactive two-day training session designed to provide NF staff with the skills necessary to help residents maintain positive control over their lives.

Participants will be introduced to the core concept of Person-Centered Thinking Training: finding a balance between what’s “important to” and “important for” the people they serve. Participants will learn how to obtain a deeper understanding of the people they support and to organize this learning to inform their efforts to help people get the lives they value.

Person-centered practices are designed to help align service resources that give people access to the benefits of community living and ensure they receive services in a way that helps them achieve their individual goals and outcomes.

Participants will practice a set of discovery, management, and everyday learning skills. At the end of the two-day training, they will feel empowered to learn more about their residents and make important changes to their practice. These changes will provide residents with a more meaningful existence, greater satisfaction, and an overall improved quality of life. Caregivers themselves will benefit by gaining an enhanced understanding of and compassion for the people they serve, thereby finding greater job satisfaction.

Who should consider attending? All staff caring for people living in NFs, especially staff supporting those who have dementia or people who have intellectual and developmental disabilities.

View the Person-Centered Thinking Training flyer (PDF) for more information.

To schedule a Person-Centered Thinking class, contact QMP staff assigned to your facility, or email QMP.

Alzheimer's Disease and Dementia Care Resources

Resources Created by HHSC

Resources from Other Organizations

Alzheimer's Association

  • Alzheimer's Disease Facts and Figures outlines the impact of Alzheimer’s disease at an individual level, as well as the burden on caregivers and the health care system.
  • Health System and Clinicians provides resources and tools for health care professionals, including guidelines for screening, assessment and medical management.

American Geriatrics Society

Centers for Disease Control and Prevention

Centers for Medicare and Medicaid Services (CMS)

Music & Memory®

  • Music & Memory® provides guidance for implementing personalized music playlists in NFs as a non-pharmacological intervention for managing BPSD.

TMF Health Quality Institute Networks

University of Iowa — Iowa Geriatric Education Center