Management: Mild to Severe
The tools and resources in this section assist in the development of a case management plan for mild-to-severe stages of cognitive impairment. A detailed care plan can be a vital resource in tracking the progression of the disease, and in providing support for the patient, family, and caregivers.
Suggested: The most effective, comprehensive, and evidence-based information.
Additional: Other approaches physicians and other caregivers may find useful.
Suggested Physician Resources
Current Pharmacologic Treatment of Dementia(annals.org)
The American Academy of Family Physicians and the American College of Physicians published a set of pharmacological practice guidelines for patients who have dementia.
Care Coordination Practice Tool(www.actonalz.org)
The Care Coordination Practice Tool was created by ACT on Alzheimer’s® to summarize the steps taken during the management of Alzheimer’s disease. It provides a workflow, a checklist, and a summary of other important definitions and information to reference when caring for patients.
Clinical Dementia Rating (CDR) Worksheet(knightadrc.wustl.edu)
The Clinical Dementia Rating Worksheet was developed by researchers at Washington University in St. Louis, MO. This tool is a battery of tests to help define the level of impairment a patient may have. A long interview is conducted by a neurologist who specializes in Alzheimer’s disease and dementia. Scoring instructions can be found here(knightadrc.wustl.edu). Other information about CDR can be found here(knightadrc.wustl.edu).
Clinical Dementia Rating Impairment Chart(23 KB PDF)
When a patient is evaluated with a clinical dementia rating (often by a neurologist) the scores can be interpreted using this scorecard developed by the American Academy of Neurology. The scorecard provides the category along with a description at each level of impairment for that category. It can be a quick reference for physicians to understand the clinical dementia rating score.
Patient, Family, and Caregiver Tools and Resources
Building a Care Team(www.alz.org)
Building a Care Team is a patient guide developed by the Alzheimer’s Association to help build a care team that will help throughout the disease and care for each facet of the patient’s life.
Alzheimer’s Disease Medications Fact Sheet(order.nia.nih.gov)
The Alzheimer’s Disease Medications Fact Sheet is provided by the National Institute on Aging. It includes several prescription drugs currently approved by the U.S. Food and Drug Administration (FDA) to treat people who have been diagnosed with Alzheimer’s disease. Available in English and Spanish.
Additional Physician Resources
Geriatric Depression Scale(16 KB PDF)
The Geriatric Depression Scale can be useful for patients who have mild-to-moderate symptoms of dementia. Score one point when the patient answer matches the test answer. A score of greater than five indicates further evaluation.
Managing Dementia Across the Continuum(static1.squarespace.com)
Adapted from ACT on Alzheimer’s®, Managing Dementia Across the Continuum is a comprehensive listing of resources for mid-to-late stage case management for the dementia patient.