Today, Mom’s social and verbal skills remain intact, but her executive function has deteriorated. The family has taken over certain tasks to ensure her safety. She is no longer driving. Although she functions independently within the home environment, her ability to make appropriate decisions is not reliable and requires monitoring. Arrangements are being made with home health for family respite care.
As a result of this experience, when I see a patient with possible dementia, I take into account the limitations of the screening tools, maintain a heightened level of concern for the emotional effort it took to bring the complaint to me, and consider a broader differential diagnosis.
Dementia is progressive and debilitating. The burden of the disease extends beyond the patient to the caregivers, with emotional and often financial stressors. Even though more research is needed to improve our ability to diagnose and treat dementia, it is important to detect it at an early stage and provide appropriate interventions. If initial screening does not identify the etiology of the dementia, using neurologic or psychological services is warranted for further testing.
Ronda Lantz practices at the University of Texas Family Medicine Clinic in San Antonio.