By Genevieve Wanucha, UW Memory and Brain Wellness Center
Primary care doctors are usually the first medical professionals to identify age-related cognitive impairment in their patients, field questions about Alzheimer’s disease, and make referrals to specialty neurology centers. A conversation in the doctor’s office about memory loss and dementia can position a patient and the family to receive quality care and plan ahead for important decisions about medical care.
According to Dr. Barak Gaster, MD, who has worked as a primary care doctor in the General Internal Medicine Center at UW Medicine or over 20 years, these conversations do not happen enough. He has observed a lack of knowledge in the primary care setting about identifying symptoms and talking to people about dementia, and the stark consequences. “Many people living with dementia have not received a diagnosis,” says Dr. Gaster. “And if people go without a diagnosis of memory loss, they may reach late- stage dementia getting care that doesn’t fit their needs or wishes.”
The reality about dementia is that people often live with the condition for a much longer time than other serious diseases, and dementia affects decision-making capacity much sooner. It is often difficult for a family to know what their loved one’s wishes would be for medical care as dementia worsens. Individuals can differ in specific attitudes about medical interventions for dementia, especially about measures to prolong life. Dr. Gaster has noticed that some of these interventions, especially for people with advanced dementia, actually reduce quality of life and can be painful for someone with cognitive impairment to endure.
In the presentation ‘Advanced Care Planning for Dementia,’ at the upcoming Central WA Alzheimer’s and Dementia Conference, Dr. Gaster will discuss how to improve early detection of dementia and advanced care planning in the primary care clinic. In his role as the Primary Care Liaison at the UW Memory and Brain Wellness Center, he developed a dementia-specific advance care directive that allows people to easily express their wishes in a way that is useful to future caregivers. His goal is to help align the medical interventions that people get with the care that they would have wanted and relieve anxiety and uncertainty. For more information: www.dementia-directive.org
Dr. Gaster’s presentation will provide insight on how patients, care partners, and medical professionals can successfully broach the topic of advanced care planning in the doctor’s office long before the situation becomes urgent. Not all memory loss is a sign of advancing dementia, and this conversation gives doctors an opportunity to highlight programs that may help improve brain health or delay cognitive decline through healthy changes in diet, sleep, and social and physical activity.
Click here for more information or to register for the Central Washington Alzheimer’s & Dementia Conference.