Continue to review and support interventions
As the condition progresses, their care and support needs may change. Monitoring and reviewing interventions is part of the ongoing management of a patient with dementia.
This may involve revisiting areas that the patient, their carer(s) or family were not initially receptive to as the disease progresses, and there are significant changes in their health condition or circumstances.
Chronic Disease Management Plans are valuable in the ongoing appropriate care (see here for further information).
Interventions
Dementia Australia – Dementia Australia can provide counselling, advice, reassurance and information and education programs. They have knowledge about the progression of the disease and the changing needs of the person living with dementia. They can also assist with linking people to suitable local services and support groups.
Driving capacity – Driving capacity and dementia severity should be re-assessed every 8-12 months for those patients with dementia who are deemed safe to continue driving. Occupational therapist driver assessment can be performed to assess driving capacity.
Advance Care Planning (ACP) – Advanced Care Plans should be revisited on a regular basis with the person with dementia, their carer(s) and family, particularly which there is a significant change in their health condition or circumstances.
Powers of Attorney – GPs can play a role in encouraging patients to appoint Enduring Powers of Attorney, Financial, Medical and Guardian. As dementia can affect decision making, it is important a person with dementia makes plans for the future while they are still able.
Medication – After starting a medication, patients should be regularly reassessed, including standardised tests of cognition and function to assess effectiveness and possible side-effects.
Employment – Dementia may cause various impairments in functioning which may affect the person's ability to do their job. Medical and neuropsychological assessments can assess the impact of dementia on capacity to work.
Lifestyle – Promoting lifestyle interventions that promote independence, engagement and function such as regular exercise, mental stimulation, establishing a routine, counselling, and social engagement or support.
General health – GPs play a major role in managing physical and psychological co-morbidities to keep a person with dementia in optimal health. This includes monitoring weight, nutritional status, blood pressure and other health conditions.