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The Growing Challenge of Neurology Deserts: A Crisis for People Living with Dementia

Written by Pam Brandon | Nov 21, 2024 5:09:10 PM

 

As the prevalence of Alzheimer’s disease and other forms of dementia continues to rise, communities across the United States are facing a critical issue: a shortage of neurologists and geriatricians, often referred to as neurology deserts. These areas, typically rural or underserved, lack access to specialized care that is essential for the early diagnosis, treatment, and management of neurological conditions. For individuals living with dementia and their care partners, the implications are profound.

Let's explore what neurology deserts are, how they impact dementia care, and what communities can do to address these challenges. We’ll also highlight the critical role of awareness, education, and programs like Dementia Live® in creating healthier, dementia-capable communities.

What Is a Neurology Desert?

A neurology desert is a geographic area with insufficient access to neurologists and other specialized providers such as geriatricians. According to the American Academy of Neurology (AAN), the United States has only about 19,000 practicing neurologists, and demand is expected to increase by 20% over the next decade.

Alarming Statistics on Neurology Shortages:

  • In 2023, 40% of U.S. counties had no practicing neurologist.
  • Rural areas are disproportionately affected, with fewer than 5 neurologists per 100,000 residents in some states.
  • The number of geriatricians, essential for addressing aging-related conditions, is also critically low. By 2050, the U.S. will need approximately 33,000 geriatricians but is on track to have fewer than half that number.

For people living with Alzheimer’s disease and dementia, these shortages mean delayed diagnoses, fragmented care, and increased reliance on emergency rooms for acute needs.

Dementia in Rural Communities

The impact of neurology deserts is especially acute in rural communities, where dementia diagnoses are rising. The Centers for Disease Control and Prevention (CDC) reports that:

  • Rural populations experience higher rates of dementia due to aging demographics and greater prevalence of risk factors like hypertension and diabetes.
  • Access to specialized dementia care is often limited, requiring families to travel long distances for appointments or forego care altogether.

This lack of access creates a cascade of challenges: delayed interventions, increased caregiver burden, and poorer outcomes for individuals living with dementia.

Addressing Neurology Deserts

To combat the growing challenge of neurology deserts, communities and organizations are adopting innovative solutions, including:

1. Telemedicine Expansion

Telemedicine is bridging the gap for rural areas, allowing patients to access neurologists and geriatricians remotely. Programs like Project ECHO (Extension for Community Healthcare Outcomes) train primary care providers in rural areas to manage complex conditions like dementia.

2. Community-Based Support

Community based organizations such as Area Agencies on Aging, are stepping up to provide dementia education and resources.  These efforts help families navigate caregiving challenges and access available support.

3. Education and Workforce Development

Training programs are being implemented to increase the number of primary care providers equipped to diagnose and manage dementia. Geriatric training initiatives aim to attract more healthcare workers to underserved areas.  Training for In-home support workers and community health workers are also boosting efforts to allow people living with dementia to remain in their homes, reducing the costly burden of nursing home care.  

4. Community Partnerships

Collaborations among community and regional stakeholders are moving the needle with many innovative efforts to bridge the private and public sectors that include health plans, community-based organizations, aging service providers, and others that have a vested interest in addressing the unique needs of their communities.  This village concept will continue to see advancement in the coming years as access to technology grows among rural and underserved areas.   

Building Dementia-Friendly Rural Communities

In the face of these challenges, building dementia-friendly and dementia-capable rural communities is more important than ever. Here’s how these efforts benefit residents:

1. Raising Awareness

Public education reduces stigma and promotes early diagnosis, ensuring that individuals receive care and support sooner. Programs like Dementia Live®, developed by AGE-u-cate Training Institute, are instrumental in creating empathy and understanding within communities, empowering powerful face to face conversations, building trust and relationships that can lead to better outcomes due to early caregiver intervention. 

2. Expanding Education and Resources

Equipping care partners with tools and knowledge improves quality of life for both caregivers and those living with dementia. Community workshops, memory cafes, care partner support groups, and skill-building programs help reduce caregiver stress and burnout.

3. Strengthening Healthcare Systems

Training primary care providers in dementia care ensures that rural residents have access to knowledgeable healthcare professionals, even in the absence of specialists.

4. Reducing Healthcare Costs

Supporting individuals to age in place, rather than relying on institutional care, reduces costly emergency room visits and hospital readmissions.

AGE-u-cate Training Institute and Dementia Live

AGE-u-cate Training Institute is at the forefront of addressing the challenges posed by neurology deserts. Through partnerships with community organizations, including Area Agencies on Aging, Dementia Friendly Initiatives, Community-based organizations and others, AGE-u-cate is delivering impactful education and training programs to rural and underserved areas.

Dementia Live®, an immersive experience that helps participants understand the sensory and cognitive challenges faced by people living with dementia, is transforming how communities approach dementia awareness, education and skill building.  By fostering empathy and awareness, Dementia Live empowers care partners, healthcare providers, and community members to create supportive environments.  The impact of in-person conversations leads to higher outcomes in the important area of early care partner intervention, thus reducing caregiver burnout and empowering care partners with resources, support and mentorship. 

 

A Call to Action

The growing prevalence of neurology deserts demands urgent attention. By expanding awareness, increasing education, and investing in community-based solutions, we can create a future where individuals living with dementia—and their care partners—receive the support they deserve.

Programs like Dementia Live® are paving the way for more inclusive, understanding, and capable communities. If your organization or community is interested in becoming part of the solution, contact AGE-u-cate Training Institute to learn more about our programs and collaborations. Together, we can build a world where no one is left behind, regardless of geography.

For inquiries about our work with Dementia Friendly initiatives, Area Agencies on Aging, the recently published Rural Age Friendly Compendium of Best Practices or general inquiries about the Dementia Live program, please contact us today. 

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