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ASSESSMENT
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Conduct
and document an assessment of: |
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- 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
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Reassessment should occur every 6 months or more frequently with
any sudden decline or behavioral change. |
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Identify
the primary caregiver and assess the adequacy of family and other
support systems. |
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Assess
the patient's decision-making capacity and whether a surrogate has
been identified. |
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Caregiver's needs and risks should be assessed and reassessed on a
regular basis. |
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Assess
the patient's and family's culture, values, primary language,
literacy level and decision-making process. |
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TREATMENT
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Develop
and implement an ongoing treatment plan with defined goals.
Include: |
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- Use of cholinesterase inhibitors,
if clinically indicated, to treat cognitive decline.
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Appropriate treatment of medical conditions.
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Referral
to adult day services for appropriate structured activities, such
as exercise and recreation.
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Treat
behavioral problems and mood disorders using: |
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- 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-pharmalogic approaches prove unsuccessful.
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EDUCATION AND SUPPORT
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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. |
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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: |
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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. |
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Discuss
the intensity of care and end of life care decisions with the
person with AD and the family. |
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REPORTING
REQUIREMENTS
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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). |
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Driving:
Report the
diagnosis of AD to your local health officer in accordance
with California law (Sections 2800 and 2812 of Title 17,
California Code of Regulations). |
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Prepared by
the California Workgroup on Guidelines for Alzheimer's Disease Management.
Supported by the California Department of Health Services and the
Alzheimer's Association,
Los Angeles, under Contract No. 00-91317, the federal Health Resources
and Services
Administration's Bureau of Primary Health Care, and the Administration on
Aging.
California Version-R 010102 © 2002
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