Care and Counseling for Patients
The Alzheimer's Disease and Memory Disorders Center at Baylor College of Medicine adopts an evidence-based approach to patient care. Persons seeking evaluation for memory or thinking difficulties are given a full battery of diagnostic tests, including lab studies, neuroimaging, neuropsychological evaluation, and a neurological evaluation.
We adhere to nationally recognized standardized diagnostic criteria to establish a diagnosis and determine the severity of the condition. The evaluation also determines whether there are other medical conditions or secondary, non-cognitive features (e.g., behavioral changes, anxiety, agitation, sleep disturbance, agitation) contributing to the memory/thinking problems.
Our patients and family members receive the support of a multidisciplinary team over the course of their illness. Similar to diabetes or heart disease, Alzheimer's disease and other progressive dementias are chronic health conditions which require periodic reassessment and routine monitoring to ensure proper treatment. Our patients are seen at least yearly for a complete checkup, including a full neuropsychological assessment to determine their response to treatment and degree of stabilization or progression. Because we follow our patients closely and for such a long period of time, we are able to address the changing needs of both the patient and those who care for him.
To achieve our goal of providing comprehensive care, the ADMDC employs a full time clinical psychologist who specializes in the non-pharmacological management of Alzheimer's disease and related disorders. We believe counseling about cognitive disorders plays a fundamental role in the care of persons with dementia. Consequently, we build this component into our care plan for all of our patients and families.
Medical counseling should not be confused with therapy. Counseling within the setting of the ADMDC is intended to educate the patient and family about their condition, determine factors influencing the immediate and long-term management of the disease, and assist in developing a treatment plan.
Treatment plans are tailored to the specific needs of each patient and family based on a psychosocial assessment performed at the time of diagnosis. An assessment of the patient's safety practices (i.e., medication management, financial management, driving, supervision with complex activities), involvement in stimulating and structured activities, opportunities for age-appropriate socialization, and relevant legal issues is conducted. The outcome of this assessment guides the discussion and dictates the need for referrals to various support services in the community.
The counseling visit is an opportunity to openly discuss the diagnosis and associated concerns of all present. Counseling visits are often requested between the time of the initial visit and annual check-up to address specific issues such as adjustment to diagnosis, respite care options, behavioral changes (e.g., loss of initiative, apathy versus depression, sleep difficulties, restlessness, agitation), caregiver distress, crisis management, residential or emergency/short term placement, difficult transitions (e.g., stopping driving, hiring home help).
Some patients and family members return for individual or family counseling because interpersonal conflicts, individual circumstances, or practical barriers are preventing them from carrying out the prescribed treatment plan.
Counseling is easily accessed by all ADMDC patients and their family members, and should be considered an integral part of the disease management process.