On the recent occasion of my 70th birthday, I decided that it was time to go radical.
With one notable exception in the 1960s (when I burned my bra to save a neighborhood library from closing) my life has been one of judicious restraint. From being a full-time mother to having a career on Wall Street, and from serving in Mayor Rudy Giuliani's inner circle to my leadership roles in the nonprofit world, my goal was always to stay on the path and get the job done without ruffling too many feathers.
As I was blowing out the birthday candles, in a moment of absolute clarity, I realized that 70 is not the new 50. Seventy is the new 70. And with this revelation came immediacy to my worry about the kind of world I am leaving to my grandchildren. It seemed time to rattle the cage.
But where would I start? The list of what ails the world is long. Global warming. Terrorism. Hunger. Poverty. The Economy.
Dad always told me, stick to what you know best. So from my eleven-year perch as CEO of the New York City Chapter of the Alzheimer's Association, it is only fitting that my radicalization confronts the "perfect storm" that is approaching us with devastating consequences. Without a medical breakthrough or the development of effective treatments, by 2050, the number of people 65 and older with Alzheimer's disease will to jump from 5.1 million to a potential high of 16 million. And at some point, every one of those Americans will need care twenty four hours a day, seven days a week.
With no prevention or cure in sight, it's clear that the U.S. health care system is unprepared to withstand the extraordinary pressure of so many people ill and needing care. Today, Alzheimer's - which can last as long as 20 years - is the only cause of death among the top ten in the United States that cannot be prevented, cured or even slowed. In fact, as the Alzheimer's Association Facts & Figures report for 2015 shows, today, one in three American seniors dies with Alzheimer's or another dementia.
In 2015, Alzheimer's and other dementias will cost the nation $226 billion. By 2050, these costs could rise as high a $1.1 trillion. Where is this money going to come from?
Our current health care system lacks adequate beds in nursing homes and hospitals and does not have enough trained health care workers for either residential or home care. Insurance coverage to supplement expenses for caregiving is inadequate and inflexible family-leave policies often force caregivers to leave the job market. And when family caregivers leave the work force, they pay fewer taxes, thereby reducing the tax base at precisely the moment when we need more money to sustain our already fragile health care system.
And the burden is not solely financial. Alzheimer's has two victims - the person with dementia and the caregiver. Caregivers and family members face enormous emotional and physical stress themselves. Studies have shown that family caregivers are more likely to suffer from depression, exhaustion, heart attack/diseases, diabetes, arthritis and other chronic condition than non-caregivers.
Our country needs an aggressive, cohesive and multi-pronged plan. The voice of the Alzheimer's community must resonate in the halls of government to ensure sustained growth in funds for care and cure. Above all, we need to incent the next generation of scientists to join the fight and spark new research.
We need to elect federal, state and city leadership who will create rational policies to support the programs, institutions and resources we will need for families and communities. And physicians must be educated on how to support the newly diagnosed as well as the growing number of those diagnosed with early onset dementia in their 40s and 50s.
The health care industry must build and sustain a committed workforce with incentives including adequate compensation, training and benefits. To support those who need help, residential care and home health care jobs should become desirable opportunities.
The looming Alzheimer's crisis is too big a challenge for government, the public or the private sector to handle alone. But we need someone to lead the charge.
There is nothing stopping me - or you - from taking an active role in this fight. Because, for sure, if we fail to make our voices heard, our generation and those that follow will pay a high price from which they may never recover.