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As Alzheimer’s Cases Climb Statewide, Community-Based Programs Offer A Lifeline For Families. Rockland County Is Home To One Of The Most Promising Models
By David Carlucci
There is a health crisis unfolding in New York that touches nearly every family, yet rarely dominates the headlines. More than 426,500 New Yorkers aged 65 and older are living with Alzheimer’s disease, and New York ranks second in the nation for projected prevalence. Nationally, more than 7 million Americans are living with Alzheimer’s, a number expected to reach nearly 13 million by 2050.
Behind every one of those numbers is a family navigating one of the hardest chapters of their lives.
Understanding Alzheimer’s and Dementia
Dementia is not a normal part of aging. It is a condition caused by diseases that damage the brain, and Alzheimer’s disease is the most common cause, accounting for 60 to 80 percent of cases. It affects memory, thinking, and behavior, and it progresses over time. People diagnosed after 65 typically live four to eight years, though some live as long as 20.
The toll extends far beyond the person diagnosed. In New York, more than 650,000 residents serve as unpaid caregivers, providing hundreds of millions of hours of care each year. These are spouses, adult children, and neighbors who put careers, finances, and their own health on hold. Caregiver burnout is one of the most serious and least discussed consequences of this disease.
The economic stakes are just as sobering. Health and long-term care costs for people living with dementia are projected to reach $409 billion nationally in 2026. In New York, Medicaid costs tied to Alzheimer’s and other dementias exceed $5 billion. As the baby boom generation ages fully into the highest-risk years, these pressures will only intensify.
New York’s Response
To its credit, New York State has recognized the scale of the challenge. Through the Alzheimer’s Disease Caregiver Support Initiative, the state invests more than $26 million annually in Centers of Excellence, regional caregiver programs, and community services. The New York State Office for the Aging has been especially forward-thinking, funding local programs and forging public-private partnerships that support brain health, combat social isolation, and give caregivers real relief.
That state leadership matters most when it reaches the county level. Rockland County’s Office for the Aging deserves particular recognition for connecting older adults and their families to services, and for supporting the kind of community-based dementia care that keeps people at home and out of institutions longer. County aging offices are often the unsung infrastructure of elder care, and Rockland’s has proven what smart, local investment can accomplish.
The Power of the Dementia Day Program Model
One of the most effective and underutilized tools in dementia care is the outpatient dementia day program. These programs give participants structured, meaningful engagement for several hours at a time: music and reminiscence activities, adaptive movement like chair yoga, art, and social connection. Research and frontline experience alike show that this kind of engagement can reduce anxiety, spark recognition, and help mitigate the behavioral challenges that families struggle with most.
Just as important, day programs give caregivers something they desperately need: a break. A few hours of respite can be the difference between a sustainable caregiving arrangement and a family in crisis. When caregivers collapse, the alternative is often premature institutionalization, at enormous human and financial cost.
Rockland County is fortunate to have the only outpatient dementia day program of its kind in the county, operated by Active Rockland at the Palisades Center. Supported by grants from the State Office for the Aging, the program has a waitlist, which indicates that while the model works, demand far outstrips supply.
A Local Mission Worth Celebrating
Active Rockland, founded by Richard Serrano in 2009 as a modest physical therapy practice in New City, has grown into a wellness organization built around a simple idea of caring for the whole person and the family around them. That mission was on full display last month, when Active Rockland celebrated the grand opening of its newest location in Haverstraw, expanding access to rehabilitation, wellness, and adult day services for more Rockland families. Serrano’s quiet, consistent work earned him a place on City & State New York’s inaugural Unsung Heroes list, and the recognition was well deserved.
However, the point is bigger than any oneorganization. Active Rockland’s dementia day program is a proof of concept for what New York should be doing everywhere: pairing state and county aging dollars with committed local providers to deliver care that is humane, effective, and far less expensive than the alternatives.
What Comes Next
New York faces a 44 percent shortfall in the geriatricians needed to meet demand by 2050. Waitlists for day programs are growing. The state has built a strong foundation, but the need is accelerating faster than the funding.
Expanding support for community-based dementia programs should be a priority in the next state budget. Every county should have what Rockland has, and Rockland should have more of it. The families navigating this disease are not asking for miracles. They are asking for a few hours of engagement for their loved one, a few hours of rest for themselves, and a system that sees them.
That is an achievable goal. Rockland is showing the way.
David Carlucci consults organizations on navigating government and securing funding. He served for ten years in the New York Senate.
