Pax Dementia…

Divide et impera, Philip II of Macedon supposedly said. Will dementia govern the same way? (Photo courtesy the fine folks at WikiMedia Commons.)

Divide et impera, Philip II of Macedon supposedly said. Will dementia govern the same way? (Photo courtesy the fine folks at WikiMedia Commons.)


Good morning, ProviderNation. The great humanist and Holocaust survivor Israel Shahak was fond of analyzing a political situation and summing things up in his thick, Polish accent: “There are encouraging signs of polarization.”

You don’t have to be a Hegelian (and, indeed, Shahak was always more of a Spinozist) to appreciate the point that, sometimes, the best way for everyone to move forward is for everyone to go at it alone. The last few weeks have brought us dispatches reporting that the Alzheimer’s Association is unravelling. Several chapters, including in New York, Los Angeles, Austin, and San Diego, have splintered off from the main body. Whatever the other recriminations in the group, it appears that a long-simmering conflict that goes beyond the association (it’s the one hash-tagged #CareVCure) has finally boiled over.

‘What We Do Best’

Just last week, the former New York chapter announced that it had changed its name to “CaringKind—The Heart Of Alzheimer’s Caregiving.” Its leaders explained themselves thusly:

“In December, when we broke away from the national Alzheimer’s Association to return to our roots as an independent charity, we knew we would need a new name that exemplified the very core of who we were: an organization with more than three decades of experience developing and implementing innovative, creative, and leading-edge caregiving initiatives.

“So, we stepped back and assessed what we did best. And what we do best—where we have always excelled—is understanding the needs of New York City caregivers and providing them with the support they need to care with confidence today and, just as important, to plan for tomorrow…”

The battle over whether to spend the money on research or for immediate care has been a long time coming. But its not the only crack in the dementia façade. Just Tuesday, the fine folks at the Dementia Action Alliance issued their own white paper, calling dementia a human rights catastrophe.

Smaller, Better?

The splintering begins just as nearly everyone says that dementia is, or is about to become, a global pandemic, laying waste to entire societies. Why, then, do so many foot soldiers and field marshals in the battle against dementia seem so sanguine about a division, even a mutiny, in the ranks?

“Sometimes, smaller is better,” says William Mansbach, president and CEO of CounterPoint Health Services. “It’s only natural that in the early days of dementia research, a dominant association would eventually emerge as an aggregator of patient and caregiving education, as well as a primary funder of and lobbying force for more research dollars. But now we’re in what you can call the second generation of our understanding of dementia. With more knowledge of the disease, and a stronger sense of urgency to find a cure, newer associations dedicated to funding dementia research and getting information out to the public have formed.”

‘They Don’t Get The Answers They Need’

The Great Dayne DuVall, chief operating officer at the National Certification Board for Alzheimer’s Care, takes things a step further. If anything, he says, the split was overdue.

“There is little to no funding for the care of people with dementia—or their family caregivers,” he says. “I believe the splintering comes from the fact that many people think that the first place they should call when they are at wit’s end is the Alzheimer’s Association—and, in reality, they don’t get the answers or resources they need.

“My family knows this first hand because we faced this at every turn with my father’s battle with Alzheimer’s disease,” DuVall says.

Don’t know if it counts as an irony, but the mutinies come just as the Alzheimer’s Association seemed ready to recognize some of the care malcontents. Last summer, the association hired Doug Pace away from Advancing Excellence and gave him the explicit mission of building up a caregiving advocacy corps.

But DuVall points out that the association’s façade has been cracking for a while.

“Remember, 50 percent of the chapters originally voted against the current move being undertaken to become a single 501(c)(3) charity,” Duvall says. “I wonder how many of their members expressed their concerns of care versus cure through their votes. I hope the association will now pay attention and spend more of their annual budget helping families find the help they so desperately need.”

Divide Et Impera?

Still, DuVall is willing to acknowledge that splitting off carries a significant risk. Nearly everyone agrees that the battle against dementia is horribly underfunded. Conservative forces in the Alzheimer’s Association can argue (and probably are already arguing) that a divided force makes it that much harder to get the Big Public, and its politicians, to focus.

And that’s just to consider the (relatively) micro-view of dementia. On Monday, the Guardian published the first in a series of articles that purported to show that young adults in America are, for the first time in the history of this republic, poorer than retirees. The data may not check out, but the mood of the piece certainly seems to have captured the gestalt. Whatever else that means, it means that, should the (apparent) preferences of younger voters prevail in this or future elections, the already politically fraught terrain of “redistribution” will become even more dangerous because it will mean, literally, taking from the old to give to the young.

“A Captain,” Machiavelli argues, “ought, among all the other actions of his, endeavor with every art to divide the forces of the enemy, either by making him suspicious of his men in whom he trusted, or by giving him cause that he has to separate his forces, and, because of this, become weaker.”

The concept—divide et impera—wasn’t new even in Il Machia’s day, but those of us who live under the awful dispensation of Pax Dementia may yet rue its incredible power.

Bill Myers is Provider’s senior editor. Email him at Follow him on Twitter, @ProviderMyers.


1 Comment

Filed under health care, Long term care, New Provider, Post-acute care, Uncategorized

One response to “Pax Dementia…

  1. Jim DesRosiers

    The CApe COd CHapter did this years ago as national was becoming a “bully”. Great news that many are going back to their roots and doing their work locally.

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