Portland Community College Portland Community College | Portland, Oregon

Gerontology Program

Advanced Behavioral & Cognitive Care Career Pathway Certificate

This certificate is designed to enhance the knowledge and develop the skills of direct care providers to work with older adults experiencing cognitive decline, dementia, and other challenging behavioral and cognitive conditions, in long term care, adult daycare, hospice, home, and community settings. The certificate would enhance the ability of any aging services professionals to work effectively with this population. The courses in this Career Pathway Certificate are wholly contained within the State Board approved Gerontology AAS Degree. Successful completion of the Certificate prepares students for the National Certification Board for Alzheimer Care (NCBAC) certification examination for designation as a Certified Alzheimer Caregiver.

The need

According to the 2019 Alzheimer's Disease Facts and Figures report published by the Alzheimer's Association:

  • An estimated 5.8 million Americans of all ages have Alzheimer's disease or another dementia.
  • Ten percent of persons 65 and over has Alzheimer's disease and millions more suffer from some level of cognitive impairment.
  • With the aging of the population the prevalence of Alzheimer's disease and dementia is expected to increase. 
  • The annual number of new cases of Alzheimer's and other dementias is projected to double by 2050.
  • Between 2019 and 2025 every state across the country is expected to experience an increase of at least 12 percent in the number of people with Alzheimer's.
  • By 2025, the number of people age 65 and older with Alzheimer's dementia is projected to reach 7.1 million — almost a 27 percent increase from the 5.6 million age 65 and older affected in 2019.
  • By 2050, the number of people age 65 and older with Alzheimer's dementia may grow to a projected 13.8 million, barring the development of medical breakthroughs to prevent, slow or cure Alzheimer's disease.
  • In Oregon alone the number of people living with Alzheimer's dementia is projected to increase from 67,000 individuals in 2019 to 84,000 in 2025 – a 25.4% increase.
  • Currently, the majority of persons with dementia and cognitive impairment are cared for in their homes, primarily by unpaid family care providers, with paid in-home caregiving increasing with the severity of impairment. Eighty-three percent of the help provided to older adults in the United States comes from family members, friends or other unpaid caregivers.  Nearly half of all caregivers (48 percent) who provide help to older adults do so for someone with Alzheimer's or another dementia.
  • Persons with dementia are high users of home and community services.
  • Persons with dementia disproportionately utilize health care services even before they enter a long term care facility. 
  • They are more likely than other Medicare beneficiaries to have a hospital stay, and average more physician visits than other Medicare beneficiaries in the same age group.
  • They often suffer from coexisting medical conditions, including hypertension, coronary heart disease, congestive heart failure, osteoarthritis, diabetes, and other cardiopulmonary or vascular diseases.
  • About 30 percent of people with dementia are living in long-term care settings, ranging from assisted living residences to skilled-nursing facilities.
  • Persons with dementia represent about half of those living in long term care facilities. Nursing home Alzheimer's Special Care Units had 73,742 beds in 2014.  These Alzheimer's special care unit beds accounted for just 4 percent of all nursing home beds, despite 50 percent of nursing home residents having Alzheimer's or other dementias. These specialize units are clearly serving only a minority of nursing home residents with dementia.
  • Total annual payments for health care, long-term care and hospice care for people with Alzheimer's or other dementias are projected to increase from $290 billion in 2019 to more than $1.1 trillion in 2050 (in 2019 dollars). This dramatic rise includes four-fold increases both in government spending under Medicare and Medicaid and in out-of-pocket spending.

The above data points to the importance of dementia care training for a wide spectrum of healthcare professionals, as well as social and financial services professionals working with an older population with multiple chronic conditions and disabilities.

Oregon and the Portland Area

There are currently some 2335 long term care providers in Oregon: skilled-nursing facilities, residential care and assisted living facilities, memory care and adult care foster homes, in addition to independent retirement communities and in-home care. The vast majority of older individuals and persons with disabilities requiring paid care, including those with cognitive impairment, receive it through home care agencies, community based centers and day care programs.

According to the Oregon Department of Human Services:

  • 6% of Oregon's population currently require long term care, and by 2025 the percent of the population requiring long term care will rise to 8%.
  • In 2015, Oregonians 65 and older made up 15% of the population, and by 2025 will make up 19% of the overall population.
  • Various sources estimate that the 65+ population will continue this upward trend, reaching 21-24% of the state's population by 2030.
  • Each day, over 70,000 Oregonians receive care in long term care communities across the state, and that number will grow as Oregon's population continues to age.
  • Oregon's population is aging at a record pace. In 2015, 645,031 Oregonians were 65 years of age or older, and, of that, 84,668 were 85 or older—the age group most likely to need care. By 2035, there will be an estimated 173,634 Oregonians over the age of 85.

The changing demographic profile of Oregon presents great opportunity as well as a need for the state to better prepare for the challenges that an older population presents. This includes the need for increasing numbers of educated professionals to meet the ever growing demand.

The prevalence of Alzheimer's disease and dementia in Oregon is similar to that of the rest of the nation. In Oregon, as in other states, Alzheimer's and other dementia care results in a significant need for long term care services and supports. According to the Alzheimer's Association:

  • Approximately 67,000 Oregonians have a diagnosis of Alzheimer's or dementia in 2019, and this number is projected to grow significantly.
  • By 2025, over 84,000 Oregonians will have a diagnosis of dementia—an over 25% increase in just six years.
  • Those living with Alzheimer's and other dementia make up 52% of all long term care residents in Oregon.
  • Broken down into type of care facility those with dementia comprise 96% of those in Memory Care, 49% of those in Adult Foster Care Homes, 35% in Residential Care, 29% in Assisted Living, and 20% of those individuals living in Skilled Nursing Care.
  • An estimated 21% of women and 14% of men will develop dementia in their remaining lifetime if they live to be at least age 55.

Assuming the average of 30% of persons with dementia living in a long term care facility, and using the industry standard of one qualified care worker for every 15 persons requiring care, we can expect that of the 67,000 persons with dementia in Oregon in 2019, 20,100 would live in long term care facilities, requiring 1,340 dementia care specialists. The remaining 70% living in their homes would also require an extensive paid labor force of qualified care workers in homes and community programs supplementing unpaid family caregivers. The estimated 25% increase in persons with some form of dementia between 2019 and 2025 points to a comparable increase in the need for care specialists.

Using the projected rate of growth in Oregon's 65+ population and in the population needing long term care, combined with the estimated number of Oregon residents with some form of dementia, the increasing need for qualified advanced behavioral and cognitive care specialists becomes apparent.

[Sources: Oregon Department of Human Services, Future of Long Term Care for Seniors and Persons with Disabilities. See also the Oregon Health Care Association, Oregon Health Care Association 2016 Oregon Long Term Care State Report, and the 2019 Alzheimer's Disease Facts and Figures].

Why choose Advanced Behavior Cognitive Care Career Pathway Certificate at PCC?

  • Easy Access/Open start and exit program
  • Online (Asynchronous) format, with some optional in-person, live-streamed, and video-recorded class meetings
  • Applied, interactive learning format
  • Faculty expertise both inside the classroom and within the community


The program is fully online (with faculty based at PCC Sylvania Campus).


  • Personal Care Provider: $13.57 average hourly wage or $28,231 average annual wage
  • Healthcare Aids: $16.54 average hourly wage or $34,421 average annual wage
  • Social and Community Service Managers (Adult Day Care Director): $31.16 average hourly wage or $64,827 average annual wage
  • Medical and Health Service Managers (Memory Care Administrator): $58.19 average hourly wage or $121,027 average annual wage

What will you learn?

Students who successfully complete this certificate program will be prepared to:

  • Work effectively as an advanced care provider with diverse individuals or groups of older persons experiencing cognitive decline, dementia, and other challenging behavioral and cognitive conditions, in long term care, adult daycare, home and community settings.
  • Conduct gerontological research relevant to advanced care issues, and apply the research to practice.
  • Adhere to professional and ethical care standards.
  • Continue to develop professional care knowledge and skills through continuing education and training.
Award Duration Fully online Limited entry
Advanced Behavioral Cognitive Care Career Pathway Certificate Less than one year career pathway certificate Yes No

What will you do?

Advanced Behavioral & Cognitive Care Specialists may work under a wide range of titles that continue to grow and transform as the changing nature of the population experiencing cognitive impairment and dementia presents new challenges, and care facilities and programs adjust accordingly. The following represents a partial list:

  • Personal Care Provider, Home Care Provider, Resident Assistant for Dementia Care
  • Certified Nursing Assistant – Dementia Care (CNA2)
  • Dementia Care Assistant, Specialist, Coordinator, Director, Consultant
  • Memory Care Residential Unit or Day Care Center Assistant, Specialist, Coordinator, Director, Consultant

Several healthcare, social work, care manager, care planner and facility administrator positions would be enhanced by a dementia care specialization. The ABCC Certificate also complements the Activity Professional Career Pathway Certificates for Activity Professionals working in Alzheimer Care Units or in long term care settings including a high percentage of persons with cognitive impairment or dementia. Other professionals working with the older population working in public, non-profit and private sectors could similarly benefit from the Certificate. These would include professionals working as social services directors, conservators and guardians, hospice workers, or in placement agencies and financial services.

Next steps

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