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Outcome Based Neuromuscular Care: Monitoring Patient Happiness as a Possible Physical Therapy Home Program Variable in Alzheimer's Disease

David L. Cross and Michael B. Cross

Alzheimer’s disease has complicated the implementation of the new health care reform law because the incidence of the disease has been increasing in staggering proportions, with no known treatment or cure. We are already adding millions of uninsured patients to the health care system, and now, patients with Alzheimer’s are intensifying the economic challenges of providing outcome oriented health care services to all Americans. There are no accepted “standard of care treatments” for patients diagnosed with that dreaded disease. Alzheimer’s disease is the sixth-leading cause of death in America, currently affecting an estimated 5.4 million people. It is estimated that someone in America develops the disease every 69 seconds and by mid-century someone will develop Alzheimer’s every 33 seconds. Monitoring an Alzheimer’s patient’s progress is important, since identifying the objective components of their physical and cognitive decline, is an essential element in the assessment of their rehabilitation outcome variables and functional independence. The incidence of Alzheimer’s disease is not limited to the elderly, since people in their 30’s, 40’s and 50’s can develop the disease. Finding an objective method to document an Alzheimer’s patient’s happiness might be clinically advantageous, because it might prove to be a meaningful reflection of their overall health. The Primary Caregiver Rating Index and the Patient Happiness Indicator has been proposed as a way to track an Alzheimer’s patients’ relative happiness, and thereby objectify one important component of their day-to-day function.