Diagnosing Dementia

Patient Dementia and Wandering: Dementia is a serious disorder facing elderly patients. After age 60, the prevalence of the disorder doubles every five years until it affects from 30-50 % of those over eighty. Dementia is also the leading cause of institutionalization in this country, with 60-80% of nursing home patients showing signs of the disorder (1).

A lot has been written about the management of the disorder in this magazine and in other sources, but little has been written about the matching of assessment and appropriate intervention, including new treatment options. The reason that is true is because medical professionals tell us patient dementia is irreversible and can only be managed. They say the only steps one can take are to reduce the risk of falls and other harm to the patient and reduce the risk of lawsuits and governmental censures to the nursing homes where patients with dementia live.

In the past year, research has shown that a disease previously thought irreversible may be reversible after all. As a result, it is important to carefully assess the patient or resident to determine to what extent he is cognitively impaired, what pattern of wandering he exhibits, and what pre-morbid lifestyle he enjoyed.

The National Guideline Clearinghouse has a protocol for wandering (2).

In it, the proper steps to assessment are described: