With the population getting older and more people depending on caregivers, New Mexico is crafting a fresh strategy to handle dementia and brain health issues until 2031.

The state Aging and Long-Term Services Department welcomes public input until June 23 on its revised dementia road map, a five-year guide meant to direct efforts for residents living with dementia along with their caregivers.

The plan update arrives at a key moment: 1 in 5 New Mexicans age 45 and older noted cognitive decline, such as memory lapses and trouble thinking, based on figures from the U.S. Centers for Disease Control and Prevention. Another 1 in 5 residents already act as a caregiver for someone with a disability or health concern.

At the same time, New Mexico's over-65 group expanded nearly 40% from 2010 to 2019, surpassing national growth rates. This pattern is expected to persist and heighten the need for dementia support.

"It means that there's a greater need for services and supports for not only the people living with dementia but also the caregivers who are supporting them," said Angelina Flores-Montoya, deputy Cabinet secretary of the state aging department.

Aging and memory care advocates hope the state's revised road map will lead to real steps for people with dementia and their caregivers. The draft shows an "awareness of what's needed," said David Davis, founder and executive director of the Santa Fe-based Memory Care Alliance.

'Taking care of their family'

Marisol Atkins portrayed her father, diagnosed with Alzheimer's disease in 2019, as a "unique fellow."

Arnold Atkins grew up in Los Alamos and Espanola before leaving New Mexico for a career as a surgeon. He came back to the state in 1999 and enjoyed its natural beauty through hunting, hiking and fishing.

Marisol Atkins served as her father's main caregiver for nearly seven years until his death in April at age 83.

This is a familiar tale in New Mexico. About 46,000 people in the state have received an Alzheimer's diagnosis, the leading type of dementia, per data from the Alzheimer's Association.

Yet the actual scope of dementia in New Mexico reaches further. About half of those with Alzheimer's never receive a formal diagnosis, noted Jim Herlihy, the Alzheimer's Association's spokesperson for the Rocky Mountain and Southwest region.

Other conditions besides Alzheimer's can trigger dementia, Davis added. He put the real number of people with dementia in the state at three or four times the 46,000 diagnosed with Alzheimer's.

The impacts of dementia extend to more than 68,000 unpaid caregivers across the state, according to the Alzheimer's Association. Together they deliver about 119 million hours of unpaid care each year, valued at $2.4 billion.

"What we find is most caregivers don't even necessarily identify as caregivers," said Flores-Montoya with the state aging department. "They don't even know that this is what they're doing; this is what they do every day, just taking care of their family."

Yet ongoing care for others affects the caregiver as well. Nearly a third of New Mexico caregivers for people with Alzheimer's reported depression, while nearly two-thirds noted another chronic disease, per CDC data.

For Marisol Atkins, caring for her father meant a big time and financial sacrifice. While her dad could handle grooming alone, he needed steady oversight in the kitchen, online and on the phone since his condition left him open to scams. Marisol Atkins said she could not work at all in 2024 due to her caregiving duties.

Caregivers must look after themselves too, Davis said. The Memory Care Alliance runs several programs to aid that aim, such as regular caregiver support groups, training sessions, social events and even outings for caregivers and those in their care.

"Those people who don't get help, those people who don't have a plan and don't take care of themselves, that becomes what we call self-neglect," Davis said. "And unfortunately, invariably, that turns into neglect or even abuse of the person they're caring for, intentional or not."

The Memory Care Alliance's programs proved an "invaluable resource," Marisol Atkins said.

"Having a place for caregivers to be with other caregivers is just critical," she said. "Having a support place where you don't have to explain the challenges you're faced with is huge."

Road map to dementia care

Once complete, the state's draft dementia plan will act as a "road map" for tackling dementia and boosting brain health in New Mexico through 2031, Flores-Montoya said.

The plan sets five main goals: advance public education and awareness, better support caregivers, create sustainable policies, expand direct services for people with dementia and strengthen the caregiving workforce, along with specific targets for each goal.

Key targets in the road map cover state-backed public awareness efforts, higher participation in caregiver training and financial aid use, creation of at least two dementia-specific professional certification paths, and progress on at least two policy steps to keep dementia services going long term.

The agency's "direct services objectives" detail some next moves for better dementia care in the state. The road map directs the aging department to back the launch of at least three new or expanded dementia-capable residential care sites, plus set up two pilot programs to improve care access and expand telehealth options for dementia-related specialty care, like neurology, psychiatry and geriatrics.

By 2031, the aim is to enhance services for people with dementia and their caregivers in all 33 New Mexico counties, Flores-Montoya said.

"When people reach out and say, 'I need help in this county,' we are able to provide them with the help that they need in that county, whether that be respite, meals, transportation, training, whatever that may be," she said.

State's effort 'encouraging'

Earlier versions of the plan led to notable shifts. The state's prior dementia plan supported adoption of the Silver Alert, a system that alerts the public about missing seniors facing cognitive decline.

Advocates hope the new roadmap sparks similar progress.

Herlihy with the Alzheimer's Association called it "certainly encouraging" to see the state pursue a long-term view on the issue. Many core elements of the road map, such as its focus on public education and caregiver supports, align with the association's work, he said.

Davis likened the Memory Care Alliance's tie to the state aging department to that of an old married couple.

"We work it out," he said. "We were promised things that didn't happen. We promised things that we weren't able to fulfill, but we keep going."

From Davis' view, the road map signals action from the state agency and Aging Secretary Emily Kaltenbach.

"I think this is leadership from Secretary Kaltenbach and her staff to actually do something and not just talk," he said.