by Cynthia Morrison, RN, ARM, CPHRM, Patient Safety Risk Manager, The Doctors Company

Alzheimer's disease is the sixth leading cause of death in the United States and is the only disease in the list of top 10 diseases that cannot be prevented, slowed, or cured.¹

Early diagnosis of dementia, requiring the expertise of a neuropsychiatric physician who specializes in it, is essential to allow for maximum quality of life.^2,3 Physicians of all specialties should become familiar with the early signs of this disease in order to refer patients with symptoms to a specialist for further testing.

The early signs of Alzheimer's are:

• Memory loss that disrupts daily life (e.g., forgetting important dates or events).
• Difficulty completing familiar tasks at home, work, or leisure (e.g., trouble driving to a familiar location or remembering the rules of a favorite game).
• Confusion with time or place.
• New problems with words in speaking or writing.
• Decreased or poor judgment.
• Changes in mood and personality.

Only 45 percent of people with Alzheimer’s disease or their caregivers report being told of the diagnosis, whereas 90 percent of people with the most common types of cancer have been told of their diagnosis.¹ The benefits of clearly explaining the Alzheimer's diagnosis include:

• Improved decision making. When patients are fully aware of their diagnosis in the early stages of the disease, they are more likely to be competent to understand options and provide informed consent for current and future treatment options. When patients are actively involved in decision making about their care, they are more likely to be compliant.
• Access to services. Knowing the diagnosis allows caregivers to obtain information about support services and plan ahead.
• Safety. Awareness of the diagnosis allows caregivers to take steps to ensure the patient is in a safe environment and identify certain activities that may need to be curtailed, such as driving.
• Social support. Knowing the diagnosis helps affected people focus on spending quality time with loved ones.

Once a patient has learned of his or her illness, physicians should:

• Educate caregivers and patients on ways to promote activity. As the disease progresses and cognitive and functional abilities decline, patients have difficulty moving and, therefore, are more vulnerable to infection. Pneumonia is often a contributing factor to the death of patients with Alzheimer's disease.
• Facilitate consults and have a system in place to track and recall patients to ensure there is appropriate follow-up.
• Consider referring patients to a mental health professional. Depression occurs in 40 percent of Alzheimer's patients and a mental health professional can help provide treatment. Other team members may include home healthcare workers, social workers, and psychologists.
       

   
Contributed by The Doctors Company. For more patient safety articles and practice tips, visit www.thedoctors.com/patientsafety.

References

1. Alzheimer's News: New Alzheimer's Association report finds less than half of people with Alzheimer's disease say they were told the diagnosis. Alzheimer's Association website. http://www.alz.org/news_and_events_facts_figs_told_diagnosis.asp. Published March 24, 2015. Accessed June 8, 2015.
2. Dementia Advocacy and Support Network. http://www.dasninternational.org. Accessed June 11, 2015.
3. 2015 Alzheimer's Disease Facts and Figures. Alzheimer's Association. http://www.alz.org/facts/downloads/facts_figures_2015.pdf. April 2015. Accessed June 10, 2015.