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Physicians Update

 
Spring 2012

Primary-Care Physicians Have Important Role in Addressing Dementia

Caring for a loved one with Alzheimer's disease or another form of dementia is an enormous challenge for family members, but primary-care physicians can do much to help.
 
The importance of the primary-care physician's role starts with the first complaints of memory problems, says Linda Ercoli, Ph.D. , director of geriatric psychology at UCLA. "There's a tendency for many physicians to attribute such complaints to normal aging," Dr. Ercoli says. "Sometimes that's what it is; other times it's not. But in either case, it's critical to listen and take these complaints seriously."

For patients known to have dementia, discussions with family members should be inclusive. "Even if someone may not understand everything being said, it's important to include that person in the conversation," Dr. Ercoli says.

At the same time, she notes, patients with dementia can't be counted on to remember or even understand everything the physician says, or to follow through on instructions. "You have to work with a family member to make sure someone else has an understanding of what you're communicating to the patient," she says.

Family members struggling with loved ones who are becoming agitated should be encouraged to view the behavioral problem as a form of communication and seek to determine the trigger. "People with mild dementia might be able to tell you, but as the dementia gets worse, the ability to put their feelings into words or even understand what they're going through diminishes," Dr. Ercoli says. "Often, the behavior is the communication." In dealing with the patient, she notes, tell caregivers to remain calm and try to be soothing; when they are anxious or raise their voice, it is more likely to escalate the behavior. And they should be advised to find a style of communication that works best for their loved one; usually this means speaking slowly and simply, without offering too many choices.

Finally, physicians should make sure family members understand the importance of seeking help. "So many adult children or spouses think they can do it alone, and they get really burned out," Dr. Ercoli says. "Providing them with information about support groups and resources is extremely beneficial."





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