Even when a diagnosis of dementia has been made, physicians may be hesitant to tell the person. Part of the reason for that is that currently a diagnosis of dementia can be made only on circumstantial behavioral information, not on clinical facts and data. In other words, a physician can’t take an image of the brain and see the presence of dementia like he or she can with heart disease or cancer. They can only arrive at a diagnosis once early signs of dementia have been observed. As a result, physicians may wait to tell the patient about the diagnosis of dementia after symptoms become more pronounced. However, a recent addition to the clinical measures followed by psychiatrists for dementia care may change that.
The American Psychiatric Association (APA)1
recently announced that they have added a “diagnosis disclosure measure” to their Dementia Management Quality Measure Set. The addition was made because the majority of psychiatrists in the association believe that everyone deserves to know the truth about their diagnosis.
An article in Medscape2
quoted Robert Paul Roca, MD, MPH, chair of the APA Council on Geriatric Psychiatry and co-chair of the working group that updated the dementia quality measures saying, “The fact that it's in the measure set will make it clear to physicians that the best practice includes revealing the diagnosis, both the diagnosis of the syndrome of dementia and the underlying condition that is most likely causing it.”
The association added a total of three new measures to their dementia management best practices. All of them signal improvements for those who are diagnosed with dementia and their families. A second new quality measure addresses the need to assess pain in patients with dementia. It is important to state this as a measure of care because dementia patients can’t articulate pain when they experience it. Their pain may be an underlying cause of agitation and behavioral outbursts. Accurately assessing pain can lead to effective treatment and increased comfort for the person suffering from dementia.
The third new measure that the APA instituted addresses the need to pay attention to medications and their appropriate use. Medications cannot cure dementia, but some may slow the progression of the disease or its symptoms like anxiety, depression, and agitation. The APA believes that as families and caregivers create positive environments and practices for their loved ones suffering from dementia, appropriate medications should be part of the equation. According to Dr. Roca, “There are FDA-approved pharmacologic treatments (medications) for dementia that are at least worth considering and offering to patients and caregivers, and there are also a host of nonpharmacologic approaches to treatment that are vital to also present to caregivers and patients."
The result of these changes may be that psychiatrists have a bigger and better tool box from which to treat those who suffer from dementia. Subsequently, this helps professional, and family caregivers manage dementia care
more efficiently. The best practice of telling patients about their diagnosis can lead to empowerment, future planning, and mitigating the challenges of dementia caregiving
. This approach gives the person suffering from dementia and their family time to adapt their lifestyle, living environment and arrange for caregivers. All in all, the devastating diagnosis can be difficult to hear, but the knowledge of what is to come can help seniors and their families prepare and provide the care that will be needed. If you’re struggling and wondering how to help a parent who refuses dementia care
, please use our blog and industry professionals as a resource.
 Updated Dementia Management Quality Measures
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