New Alzheimer’s Drugs You Can Use at Home: What OC Families Need to Know

A revolution is underway in Alzheimer’s treatment, and for the first time, some of the most promising new therapies can be administered at home. The FDA approvals of lecanemab (Leqembi) and donanemab (Kisunla) — the first drugs shown to actually slow the progression of Alzheimer’s disease — are changing the treatment landscape. And with the development of at-home infusion protocols and subcutaneous injection formulations, Orange County families no longer need to make repeated trips to hospital infusion centers. Here’s what you need to know about these groundbreaking treatments and how they can be accessed from the comfort of home.

New at-home treatments target the brain changes caused by Alzheimer’s disease (Public Domain)

The New Wave of Alzheimer’s Drugs

For decades, Alzheimer’s treatment was limited to drugs that managed symptoms without affecting the underlying disease. The cholinesterase inhibitors (donepezil, rivastigmine, galantamine) and memantine helped with cognitive symptoms but did nothing to slow the relentless brain cell death caused by the disease. The approval of lecanemab and donanemab represents a fundamental shift — these are the first drugs proven to slow cognitive decline by targeting the amyloid plaques that are a hallmark of Alzheimer’s.

Lecanemab (Leqembi)

Lecanemab, marketed as Leqembi, received full FDA approval in July 2023. It is a monoclonal antibody that targets and removes amyloid beta plaques from the brain. In clinical trials, lecanemab slowed cognitive decline by 27% over 18 months compared to placebo — a statistically and clinically meaningful result.

Donanemab (Kisunla)

Donanemab, marketed as Kisunla, received FDA approval in July 2024. It targets a slightly different form of amyloid plaque and showed even more impressive results in patients with early-stage disease — slowing decline by up to 35%. Uniquely, donanemab can potentially be discontinued once amyloid plaques are sufficiently cleared, unlike lecanemab which requires ongoing treatment.

Brain imaging helps doctors monitor treatment effectiveness for Alzheimer’s patients (Public Domain)

At-Home Treatment: How It Works

Traditionally, these anti-amyloid antibodies required IV infusion at a hospital or specialized infusion center, involving hours of chair time plus travel. For elderly patients with dementia, these repeated trips can be disorienting, exhausting, and logistically challenging for caregivers. The development of at-home infusion services and subcutaneous injection formulations is changing this equation.

Home Infusion Services

Home infusion nursing services bring the treatment to the patient. A trained infusion nurse arrives at the patient’s home with all necessary equipment, administers the IV infusion, monitors for adverse reactions, and stays for the required observation period. This eliminates the need for transportation to and from an infusion center, waiting room time, and the stress of an unfamiliar clinical environment.

Subcutaneous Formulations (Coming Soon)

Eisai (the manufacturer of lecanemab) is developing a subcutaneous injection formulation that could potentially be administered at home by a caregiver or even self-administered. This would convert the treatment from a 60-minute IV infusion to a simple injection that takes minutes. Clinical trials for the subcutaneous formulation are ongoing, with results expected in 2026.

Understanding Alzheimer’s neuropathology drives the development of new home-based treatments (Public Domain)

Who Is Eligible for Treatment

Not everyone with Alzheimer’s is a candidate for these new drugs. Eligibility criteria include early-stage Alzheimer’s disease (mild cognitive impairment or mild dementia), confirmed amyloid pathology (via PET scan or spinal fluid test), no history of significant brain bleeding, ability to undergo regular MRI monitoring, and a willing caregiver who can monitor for side effects.

Important Safety Considerations

The most significant risk of anti-amyloid therapy is ARIA (Amyloid-Related Imaging Abnormalities), which can manifest as brain swelling (ARIA-E) or microbleeds (ARIA-H). While most cases are mild and resolve on their own, regular MRI monitoring is required to detect ARIA early. Patients taking blood thinners are at higher risk and may not be suitable candidates.

Paying for Treatment: Insurance and Medicare

Medicare Coverage

Medicare covers lecanemab and donanemab for eligible patients under specific conditions. Traditional Medicare (Part B) covers the infusion, though copayments apply (typically 20% after meeting the deductible). Medicare Advantage plans vary in their coverage. Some plans have been slower to add these drugs to their formularies.

Financial Assistance

Both Eisai (Leqembi) and Eli Lilly (Kisunla) offer patient assistance programs for those who qualify. Additionally, the GUIDE Model (if enrolled) can help coordinate care and cover ancillary costs.

The Role of Home Care in Alzheimer’s Treatment

These new drugs don’t cure Alzheimer’s — they slow it. Patients still need comprehensive support for daily living, and that’s where in-home caregivers play an essential role. At Home VA Staffing provides dementia-trained caregivers who can assist on infusion days by keeping the patient calm and comfortable, monitor for side effects between infusion sessions, maintain daily routines and activities that support cognitive health, prepare nutritious meals and manage hydration, accompany patients to MRI monitoring appointments, and provide respite care for family caregivers.

If you’re considering these new treatments for your loved one, having professional caregiver support can make the difference between successful, sustained treatment and discontinuation due to logistical challenges.

Orange County Alzheimer’s Resources

• UCI MIND (Memory Impairment and Neurological Disorders): Leading Alzheimer’s research and treatment center. (949) 824-3253
• Hoag Neurosciences Institute: Comprehensive neurological care including infusion services. (949) 764-6066
• Alzheimer’s Association OC: Support groups, education, 24/7 helpline (800) 272-3900
• Medicare GUIDE Model: Free care navigation and respite for dementia patients. Learn more
• At Home VA Staffing: (213) 326-7452 — Dementia-specialized in-home care

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