Caring for seniors with dementia and their caregivers: A guide for physicians

July 3, 2018, Canadian Medical Association Journal
Credit: CC0 Public Domain

Community-based health care providers, such as physicians, nurse practitioners and others, should be aware of services and resources to help people living at home with dementia as well as their caregivers. A review in CMAJ (Canadian Medical Association Journal) aims to provide guidance to health care providers as well as government and health system planners, based on recent evidence.

"All should be aware of their local resources for dementia and which services may be most beneficial for their patients and caregivers," writes Dr. Dallas Seitz, Queen's University, Kingston, Ontario, with coauthors. "Health system planners and policy-makers should be aware of services that have been shown to be beneficial for people and plan to meet the increasing demand for these services in the future."

In Canada, over 500 000 people are affected by dementia, and society spends $15 billion annually caring for this population.

Highlights of the review:

  • Early detection of dementia is an important first step for accessing services by proactively identifying people at risk (case finding) rather than through broad population screening programs. Identifying dementia early can relieve stress and uncertainty for patients and their caregivers and facilitate early connection to supports.
  • Evaluation for dementia should include patient history of cognitive and functional changes, medication review, cognitive screening tests, blood work and neuroimaging in some situations.
  • Community-based supports, such as in-home support services, caregiver education and training, respite programs and more, have been shown to delay admission to long-term care facilities.
  • Caregiver education programs and coordination of care have been effective at delaying placement in homes and are cost-effective.
  • Reducing caregiver stress is important for keeping people at home as long as possible.
  • Referral to dementia specialists may need to be selective, given the limited number of specialists and the increasing number of people with dementia. Referrals should be made when there is diagnostic uncertainty, marked change in a person's behaviour, challenges with medication and other complicating problems.

Some parts of Canada may currently have limited access to supports mentioned in the review.

"The identification and care of community-dwelling people with dementia and their caregivers is complex and will often involve multiple supports and services to optimize outcomes. Existing guideline recommendations for dementia and high-quality evidence underscore that community-level multicomponent supports, including caregiver education and training programs, some forms of respite programs and case management approaches for dementia, are effective in delaying admission to long-term care settings for older adults with dementia and reducing stress," the authors conclude.

"Care of community-dwelling older adults with and their caregivers" is published July 3, 2018.

Explore further: Core elements identified for successful transitions in care for older adults with dementia

More information: Canadian Medical Association Journal (2018). www.cmaj.ca/lookup/doi/10.1503/cmaj.cmaj.170920

Related Stories

Core elements identified for successful transitions in care for older adults with dementia

March 15, 2018
For older adults with multiple chronic conditions and complex care requirements, transitioning between levels of care and across care settings is common. It is well understood that high-quality transitional care is important ...

Clinicians should address needs of family caregivers of persons with dementia

December 5, 2016
More than 15 million family members and other unpaid caregivers provide care to persons living with dementia in the United States. Yet the current healthcare environment and reimbursement models emphasize obligations toward ...

Study explores impact of early dementia screening of older adults on their family members

June 23, 2016
A new grant to the Indiana University Center for Aging Research from the National Institute on Aging funds the first study to assess the potential benefits and harms to family members of early dementia screening of older ...

Effects of at-home cognitive stimulation therapy on dementia patients and caregivers

March 28, 2017
Individual Cognitive Stimulation Therapy (iCST), an intervention carried out at home by family caregivers, has little impact on the cognition of patients with dementia, a new study has found, but boosts the quality of the ...

Living at home with dementia

December 19, 2013
Most people with dementia who live at home have multiple unmet health and welfare needs, any number of which could jeopardize their ability to remain home for as long as they desire, new Johns Hopkins research suggests.

Home-based activity program helps older veterans with dementia maintain function

November 29, 2017
People with dementia often have behavioral symptoms. These include problems with memory, language, and decision-making abilities. People with dementia can also experience changes in mood, such as increased irritability, ...

Recommended for you

New discoveries predict ability to forecast dementia from single molecule

December 11, 2018
Scientists who recently identified the molecular start of Alzheimer's disease have used that finding to determine that it should be possible to forecast which type of dementia will develop over time—a form of personalized ...

Researchers classify Alzheimer's patients in six subgroups

December 5, 2018
Researchers studying Alzheimer's disease have created an approach to classify patients with Alzheimer's disease, a finding that may open the door for personalized treatments.

Neuroscientists pinpoint genes tied to dementia

December 3, 2018
A UCLA-led research team has identified genetic processes involved in the neurodegeneration that occurs in dementia—an important step on the path toward developing therapies that could slow or halt the course of the disease. ...

Detecting signs of neurodegeneration earlier and more accurately

November 30, 2018
Signs of neurodegenerative diseases, appearing years before the emergence of clinical manifestations, can be detected during the examination of medical samples by means of fluorescence microscopy by using new sensitive and ...

Never-before-seen DNA recombination in the brain linked to Alzheimer's disease

November 21, 2018
Scientists from Sanford Burnham Prebys Medical Discovery Institute (SBP) have identified gene recombination in neurons that produces thousands of new gene variants within Alzheimer's disease brains. The study, published today ...

New information on the pathological mechanisms of Alzheimer's disease

November 21, 2018
Researchers at the University of Helsinki have discovered a mechanism by which harmful tau protein aggregates are transmitted between neurons. Alongside amyloid plaques, tau aggregates in the brain are a significant factor ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.