ACTonALZ. (2014, December 2). Delivering an Alzheimer's disease diagnosis [Video]. YouTube. https://www.youtube.com/watch?v=vy2ZC5ZSZL8
Case Scenario
You are the APRN at a large hospital outpatient memory clinic. You are working with a team that includes a geriatrician, neurologist, neuropsychologist, social worker, and ancillary providers. The current protocol for patient evaluation of cognitive conditions is based on evidence-based guidelines. In addition to a complete patient history and physical (H & P), this protocol includes lab value evaluations of vitamin B & D levels, a CMP, CBC, inflammatory markers, and a preliminary neuroimaging CAT scan. Additionally, a two-hour outpatient visit with the neuropsychologist for cognitive testing and depression screening is completed. Final results and the diagnosis will include the patient’s primary care provider (PCP) in the follow-up meeting.
You have previously met the patient and his wife at the first clinic visit. They have completed the work up, as detailed above, which is similar to what is described in this video. They now come to the clinic for a final diagnosis.
Follow-up final diagnosis meeting
You and the PCP meet with the couple and relay the results of the testing. The conclusion is vascular dementia. After a few minutes, the PCP gets called away, and you are left with the couple who sits there looking bewildered.
What should you do next?
1. What questions would you ask the couple?
2. How would you know when to proceed with the visit?
3. How would you enhance the rapport you have already made during your previous meeting?
4. How would you deliver your treatment plan?
5. How would you follow up to monitor the plan interventions?
Dementia is an umbrella term for many different diseases. People often think of Alzheimer’s disease (AD) as a different entity. Sometimes a diagnosis of dementia does not mean as much as a diagnosis of AD. Yet, the outcomes are the same. People react differently to news, good or bad, and someone with dementia may not know how to react.