Key Points ÎMore than 5 million Americans now have Alzheimer's Disease (AD).
ÎAD progressively destroys brain cells, causing problems with memory, thinking, and behavior severe enough to affect work, family and social relationships, eventually, the most basic activities of daily living and, finally, death.
ÎAD is the 7th leading cause of death in the United States, and the 5th leading cause for individuals 65 and older.
ÎHCPs should be able to provide or recommend a wide variety of services beyond medical management of AD and comorbid conditions, including recommendations regarding psychosocial issues, assistance to families and caregivers, and referral to legal and financial resources in the community.
ÎMany specialized services are available to help patients and families manage AD.
Assessment Recommendations
ÎConduct and document an assessment, and monitor changes in: > Daily functioning, including feeding, bathing, dressing, mobility, toileting, continence, and ability to manage finances and medications
> Cognitive status using a reliable and valid instrument > Comorbid medical conditions which may present with sudden worsening in cognition, function, or as change in behavior
> Behavioral symptoms, psychotic symptoms, and depression > Medications, both prescription and non-prescription (at every visit) > Living arrangement, safety, care needs, and abuse and/or neglect. Need for palliative and/or end-of-life care planning
ÎReassessment should occur at least every 6 months, and sudden changes in behavior or increase in the rate of decline should trigger an urgent visit to the HCP.
ÎIdentify the primary caregiver and assess the adequacy of family and other support systems, paying particular attention to the caregiver's own mental and physical health.
ÎAssess the patient's decision-making capacity and determine whether a surrogate has been identified.
ÎIdentify the patient's and family's culture, values, primary language, literacy level, and decision-making process.
