EDITORIAL: Keep Alzheimer's patients out of Mendota

April 23--The math is pretty simple.

Care for a dementia patient at Mendota Mental Health Institute in Madison costs about $1,000 a day. Care for the same patient in community settings runs around $400 a day.

That's a difference for taxpayers of $18,000 a month.

So state and local officials are wisely trying to stem the flow of Alzheimer's patients to mental health facilities. Nursing homes and other community-based facilities are better for most everyone's bottom lines and well-being.

But redesigning Wisconsin's complicated and strained long-term care system won't be easy, especially with the growing number of patients with chronic memory loss.

When confused or frustrated, when loved ones and care providers appear as strangers, Alzheimer's patients can become combative or try to flee. That's why many nursing homes are reluctant to take the most difficult cases. When problems occur, they can face fines and other sanctions from the state.

Nursing homes and assisted-living facilities need more incentive and help to handle more dementia patients. Family and friends need training and support, too.

The State Journal's in-depth look at Alzheimer's this week by medical reporter David Wahlberg highlighted the challenges and the hopes of patients, their loved ones, local researchers and public officials.

Mendota is designed for people with psychiatric conditions, so it's too loud, restrictive and institutional for most Alzheimer's patients. That's why Dane County's Dementia Support Team is so important. The team includes a host of advocates and a doctor who specializes in geriatric medicine.

When dementia patients supported by county programs are placed at Mendota or have escalating behaviors in other settings, team members try to find the underlying trigger. One man, for example, kept throwing his lunch tray until the team discovered he never liked milk. A Korean War vet calmed after he was moved so planes weren't flying over his room.

The Dane County model should expand statewide if it continues to show strong results. The state also should pursue its plan to expand the number of facilities that can accept emergency protective placements while clarifying its rules. Nursing homes need more assurance they won't be penalized for doing the right thing.

Alzheimer's is a huge and expensive challenge. Mental health facilities aren't the answer.

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