Family Medicine Clerkship

Curriculum Resources

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Dementia

OVERVIEW

TOPIC LEARNING GOALS AND OBJECTIVES
(Organized by ACGME Competencies)

Patient Care

GOAL: Students will accurately assess a patient who presents with a change in mental status.

OBJECTIVES: Students will be able to:

• Perform a comprehensive history and physical assessment of a patient with altered mental status.
• Perform a Mini-Mental Status exam on a patient with altered mental status.

GOAL: Students will appropriately discuss dementia.

OBJECTIVES: Students will be able to:

• Describe to patients and their families/caregivers the prognosis of patients who are diagnosed with dementia.

GOAL: Students will be sensitive to individual and cultural differences in the development of treatment plans for patients with dementia.

OBJECTIVES: Students will be able to:

• Discuss with patients and families the importance of environment in improving quality of life for the patient with dementia.
• Develop treatment plans for a patient with dementia in the context of each patient's life and environment.
• Incorporate input from family and caregivers into the management plan.

Medical Knowledge

GOAL: Students will distinguish between dementia and delirium.

OBJECTIVES: Students will be able to:

• Discuss the differences in history and presentation between dementia and delirium.
• List the differential diagnosis of dementia and delirium.

GOAL: Students will recognize the psychological and socioeconomic impact of dementia on a patient and the family/caregivers.

OBJECTIVES: Students will be able to:

• Describe the natural progression of illness in a patient with dementia.
• Explain the roles of family and caregivers in the care of the patient with dementia.

GOAL: Students will understand the rationale for the management of the patient with dementia.

OBJECTIVES: Students will be able to:

• Describe appropriate therapies for the patient with dementia including the role of PT/OT, nursing, home care, hospice, and other community organizations.
• Discuss the need for environmental modifications to enhance function of the patient with dementia.
• Discuss commonly used medications in the treatment of dementia including cost-effectiveness.

Practice-Based Learning and Improvement

GOAL: Students will understand the role of the family physician in caring for the patient with dementia in practice and community settings (e.g., home care, nursing home, or assisted living).

OBJECTIVES: Students will be able to:

• Perform a home assessment of a patient with dementia.
• Interview a caregiver of patient with dementia.
• Describe the role of the practice in providing care to the patient with dementia across multiple settings.

GOAL: Students will bring up-to-date evidence to the point of clinical care.

OBJECTIVES: Students will be able to:

• Identify gaps in their own knowledge and frame appropriate clinical questions relating to the care of the patient with dementia.

Interpersonal and Communication Skills

GOAL: Students will understand the importance of effective communication with demented patients and their families/caregivers:

OBJECTIVES: Students will be able to:

• Counsel a family and patient on the long-term treatment plans for a demented patient, including the integration of available social services.
• Include patients and families in the development of treatment plans.
• Demonstrate effective listening skills and empathy to family members and caregivers who are involved in the care of a patient with dementia.

Professionalism

GOAL: Students will care for patients with dementia from diverse patient backgrounds and in different settings.

OBJECTIVES: Students will be able to:

• Respond helpfully to demented patients and their families/caregivers who are not adhering to treatment plans.
• Reflect on personal frustrations when patients are not adherent to plans.
• Analyze the role of caregiver in relationship to culture, age, gender, and disabilities.

Systems-Based Practice

GOAL: Students will understand the impact of health care systems and environment on the health outcomes of patients with dementia

OBJECTIVES: Students will be able to:

• Access community-based services available in the practice community to assist in the care of the patient with dementia.
• Analyze barriers to effective integrated care of the patient with dementia (e.g., financial and political barriers).
• Consider the role of other disciplines (e.g., nursing, social work, and PT/OT, in addition to community agencies) in the care of the patient with dementia.

EDUCATIONAL METHODS AND RESOURCES

Problem-Based Learning

• Rich Usatine has a PBL case.
  
• Mark Quirk has a PBL case, and information on a videotape on how to do the Mini Mental State Exam - Jeff Cummings is the creator of the videotape.

Published Material

• UK Gateway to Dementia information

Contact People

• STFM Group On Geriatric Education - Chris Arenson

Other

• PDA Resources - for example Inforetriever has a MMSE tool

Lead Author: Janice Nevin, MD
Clerkship/Post-Clerkship Workgroup members: Ann O'Brien-Gonzales, PhD (Chair), Alexander Chessman, MD (EC Liaison), Caryl Heaton, DO, Janice Nevin, MD, MPH, Lauren Oshman, MD, Deborah McPherson, MD, Mark. E Quirk, EdD, David Schneider, MD, MSPH, William B. Shore, MD, Richard Usatine, MD

Family Medicine Curriculum Resource (FMCR) Project HRSA Contract 240-00-0107.

For questions or comments, please contact Webmaster or Ardis Davis

This page last updated November 6, 2004