Transcript No Slide Title

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
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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
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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?
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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
GO
GATORS!