1) Ensure proper
diagnosis of dementia
There is no
single one test to diagnose if someone has dementia. The diagnoses of
Alzheimer's and other types of dementia are based on a careful medical history,
a physical examination, cognitive testing, laboratory tests, the characteristic
changes in thinking, function and behavior associated with each type of dementia
and the possible use of brain scans (CT scan and MRI). To determine that a
person has dementia with a high level of certainty is easier but it is harder to
determine the exact type or cause of dementia because the symptoms and brain
changes of different dementias can overlap. Sometimes the family doctor may need
to refer the patient to the specialists like neurologists, psychiatrists or
geriatric medical specialists.
2) Assess
safety
The behavior of
the patient with dementia needs to be closely monitored, especially to make sure
patient does not pose harm to self or others. Family members and general
practitioner need to pay attention in the areas of wandering, neglect, abuse and
driving.
3) Assess and
treat co-morbid medical illness
Patients with
dementia still require regular checkups and health assessments like other
patients. Many common illnesses can make the dementia worse.
4) Caregiver
education and support
To look after a
family member with dementia can be demanding and exhausting. It is important the
caregiver understands the disease. Education and support for the caregivers are
vital.
5) Community
resource
Alzheimer’s
Society will be a good resource to patients, caregivers and health care
providers. Day programs, home supports, respite care, long term care can be all
appropriate treatment options depending on the stage of disease.
6)
Behavioural problems
Behavioural
problems like agitation, aggression, depression and anxiety can be challenging
and may require the help of a specialist.
7) Cognitive
decline
Treat (prevent?)
cognitive decline---please refer to the following week.
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