Dementia and Alzheimer's Disease: Providing Quality Care to Patients with Dementia

Brian Unwin, MD, FAAFP

Brian Unwin, MD, FAAFP

TIME & PLACE: 3:30-4:30 Thursday, Hemisfair Ballroom C2.

ABOUT THE PRESENTER: Brian Unwin, MD, FAAFP, is associate professor of internal medicine, at the Virginia Tech Carilion School of Medicine and section chief, geriatrics and palliative medicine, at Carilion Clinic. He was the Department of Defense representative to the National Alzheimer's Project Act while he served in the military, and was the AAFP representative to the Dementia Management Update Quality Measures Set Work Group in 2013 and in 2015. He has presented at FMX on related topics in the past.

SESSION OVERVIEW: Unwin's talk will represent the latest Dementia Measures Group report, released by the multi-disciplinary group in May, which covers how physicians can improve care for patients with dementia and what that quality of care would look like.

Dementia frustrates physicians because unlike treating diabetes, hypertension, or heart disease—no medicine, shot, surgery, or implanted device reverses effects and improves a patient.

"The pills that we have for treating dementia don't do a lot, and they are problem-prone and not very rewarding," Unwin said. "So my emphasis is going to be to de-emphasize the medicalization of this condition and to emphasize the caring and importance of education and relationship with patients and caregivers to help guide and help families navigate through this horrible disease."

WHY THIS SESSION MATTERS TO FAMILY PHYSICIANS: A fifth of Americans over 65 are likely to develop dementia and about 40 percent over 85 show meaningful cognitive impairment, and with the number of older Americans expected to almost triple by 2040, Unwin said he sees a "tsunami" of older adults with these problems coming.

"There never will be enough neurologists, and there will never be enough geriatricians to manage it," he said. "This is fully, truly, and completely a condition that needs to be managed by family medicine doctors—who have, hopefully, known their patients and walked with them— to guide them through this most difficult, troubling disease."

TAKE-HOME MESSAGES: Few patients or caregivers receive a formal diagnosis of dementia, and affect planning for the future. In addition, patients and caregivers need education. Family physicians should assess patients' ability to drive, cook, manage finances, and make decisions, as well as help families man- age behavioral problems related to dementia and plan for making advance directives and care decisions, including the tough choice of moving a loved one into a care facility.