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The Initial Visit to the Doctor for a Dementia Work-up: What to Expect . Josepha A. Cheong, MD University of Florida Departments of Psychiatry and Neurology Chief, Division of Geriatric Psychiatry . What to Bring. Copies of medical summaries List of current medications
The Initial Visit to the Doctor for a Dementia Work-up:What to Expect Josepha A. Cheong, MD University of Florida Departments of Psychiatry and Neurology Chief, Division of Geriatric Psychiatry
What to Bring • Copies of medical summaries • List of current medications • When in doubt, bring the bottles of all the medications being taken • Remember both prescription as well as over the counter medications • Original studies • Reports • Actual scans – CAT and MRI
Telling the Story • What? • Short term memory • Long term memory • Particular difficulty with speech • Decreased number of words • Increased time to respond • Word finding difficulty • “tip of the tongue”
Telling the Story • What? • Difficulty with activities of daily living – both basic and complex • Self care • Driving • Balancing a checkbook • Cooking • Changes in personality
Telling the Story • When? • The changes began to be noticeable • The changes became much worse • Use the holidays as a marker when trying to estimate the length of time • “he seemed ok when I last visited at Thanksgiving but at New Year’s he had stopped driving because of constantly getting lost”
Telling the Story • When? • Longterm – over a defined length of time • Episodic – when symptoms start and when they end • Consider if any particular stimulus or event seems time-related
Telling the Story • Why? • Why now is an evaluation being sought? • Issues of safety • Issues of care • Any particular stressors?
Telling the Story • Who? • Who conducted any previous evaluations? • Who is the current treating physician? • Who will be doing the follow-up after this evaluation? • Who is the primary caregiver? • Who lives in the same residence?
Telling the Story • Where? • Where does the patient live? • Is placement in a care facility being considered and if so – where?
The Clinic Visit • Be prepared to wait – bring a book or magazines • Check to see if any tests are order to be done before the clinic visit – if done at an outside facility – bring the results • Be prepared with insurance/funding information
The Clinic Visit • History of present illness • Mental exam testing – “paper and pencil” • Physical exam • Neurological exam • Review of lab values and studies
UF Memory Disorder Clinic • Evaluation by a neurologist • Evaluation by Dr. Heilman • Psychiatric evaluation by Dr. Cheong • Psychosocial inventory and counseling by Dr. Leilani Doty
Referral Shands at UF Inpatient Geriatric Psychiatry Unit Intake Coordinator 352-265-5411 UF Memory Disorder Clinic 352-392-3491