Daily function, including feeding,
bathing, dressing, mobility, toileting, continence and ability to manage
finances and medications.
Cognitive status using a reliable and
valid instrument (e.g. the MMSE).
Other medical conditions.
Behavioral problems, psychotic
symptoms, or depression.
Reassessment should occur every 6 months or more frequently with any sudden decline or behavioral change.
Identify the primary caregiver and assess the adequacy of family and other
support systems.
Assess the patient's decision-making capacity and whether a surrogate has been identified.
Caregiver's needs and risks should be assessed and reassessed on a regular basis.
Assess the patient's and family's culture, values, primary language, literacy level and decision-making process.
TREATMENT
Develop and implement an ongoing treatment plan with defined goals. Include:
Use of cholinesterase inhibitors, if clinically indicated, to treat cognitive decline.
Appropriate treatment of medical conditions.
Referral to adult day services for appropriate structured activities, such as exercise and recreation.
Treat behavioral problems and mood disorders using:
Non-pharmacologic approaches, such as environmental modification, task simplification, appropriate activities, etc.
Referral to social service agencies or support organizations, including the Alzheimer's Association's Safe Return Program
for people who may wander.
Medications, if clinically indicated and non-pharmacological approaches prove unsuccessful.
PATIENT AND CAREGIVER EDUCATION & SUPPORT
Discuss the diagnosis, progression, treatment
choices and goals of AD care with the patient and family in a manner consistent
with their values, preferences and the patient's abilities.
Refer to support organizations for educational
materials on community resources, support groups, legal and financial issues,
respite care, future care needs and options. Organizations include:
Discuss the patient's need to make care choices at all stages of the disease through the use
of advance directives and identification of surrogates for medical and legal decision-making.
Discuss the intensity of care and end of life care decisions with the person with AD and the
family.
REPORTING REQUIREMENTS
Abuse
Monitor for evidence of and report all suspicions of abuse (physical, sexual,
financial, neglect, isolation, abandonment) to Adult Protective Services or your
local police department, as required by law (California Welfare Institution Code
15630).
Alzheimer's Disease
Program
Mail Station 7210
Post Office Box 997413
Sacramento, CA 95899-7413
Phone (916) 552-8995
Fax (916) 552-9910
Internet: www.dhs.ca.gov/Alzheimers/
