Resources for Public Health and Providers
Physicians and other medical professionals are a central part of a person with Alzheimer’s disease’s care team. Other members include family, friends, pharmacists, care specialists, caregivers and others who work together to ensure the best care possible is provided. Effective communication is important among the entire care team, particularly with health care providers.
Early detection and accurate diagnosis of dementia is critical in providing care for those experiencing cogntive decline, for managing comorbities, assuring healthcare wishes are respected, and providing apporpriate care for caregivers. Below you will find a series of frequently asked questions (FAQs) and resources for healthcare providers. While there are a multitude of resources on available on this site, this is not inclusive of all resources and scientific evidence avaible to providers.
Providing pateints with an early and accurate diagnosis offers benefits to the patient, caregiver, and for the provider. Providng an early diagnosis allows you to work with other members of your healthcare team and the patient to develop a careplan that aids in managing comorbidities, honoring the wishes of the patient, and establsihes realistic goals of care. The Alzheimer's Association has developed a Cognitive Impairement Care Planning Toolkit that outlines the pieces of the careplan and assessment needed for billing purposes. The CDC also provides a sample care plan that is user friendly.
Benefits to the patient in recieveing an early and accurate diagnosis includes:
- Opportunities to establish care partners
- Advanced care planning
- Preparing financially
- Accessing suppport groups
- Accessing community resources
- Avoiding or addressing potential safety issues
- Opportunities to particpate in research opportunities
While the Tennessee Department of Health does not endorse any specific screening tools, some options are provided below.
- Mini-Cog: Consist of three word registration, clock drawing, and three word recall to help determine cognitive impairement.
- Montreal Cognitive Assessment: 30-question test that helps healthcare professionals detect cogntive impairements.
- St. Louis University Mental Status: Patient is asked a series of questions and a score is calculated (30 being the best score) and normal, cogntive impairement, and dementia states are determined.
- Quick Dementia Rating System: Respondents are asked to rate change in teh patient in 10 categories that cover cognitive and functional abilties.
Addtiional tools can be found on the National Institute on Aging webstie by clicking here.
Eligable healthcare providers including physicialns, nurse practitionjers, clinical nurse specialists, and physician assistants, may use CPT® code 99483 for a comprehensive clincal visist that results in a written care plan. The 2018 CPT® manual provides the full description and instrucitons for the biling code. More details can be found by clicking here.
Additional relevant CPT® cods are 99497 and 99498, the codes for advanced care planning. Billing descriptors can be found by clicking here.
There are multiple tools available to assist in managing your patient's care and assisting in managing the care of someone living with dementia. The Alzheiemr's Association published the "Alzheimer's Association Dementia Care Practice Recommendations" for healthcare providers that can be utilized by healthcare providers. The National Institute on Aging offers tips for talking with older patients and a best practice caregiving tool for providers to utilize when careing for their patients. Click here to access NIA tools.
Once providing a patient with a diagnosis, the initial step is providing detailed information about their specific form of dementia and referring them to support such as the local Alzheimer's Association office, Alzheimer's Tennessee, or the local Area Agencies on Aging and Disability. A Clinical Provider Practice Tool was adapted from the ACT on Alzheimer's tools and resources to include Tennessee specific tools and resources. Click here to access the tool.
The Office of Patient Care Advocacy also developed a Caregiver Quick Guide to assist caregivers in taking the first steps after their loved one has recieved a diagnosis. These can be printed and provided to caregivers during vists.
Additional publications can be ordered at no cost from the National Institute on Aging for patient and caregiver education about various types of dementia. To order publications, click here.
There are many trainings avaiable for healthcare providers and other members of the healthcare team through various professional organizations or associations, through non-profits, and through government entities. A few of these trainings are provided below, but this is not an inclusive list of opportunities.
Health Resources and Services Administration (HRSA): Offers training titled, "Training Curriculum: Alzheimer's Disease and Related Dementias," for the primary care workforce about dementia and caregiver needs. More inforamtion can be found by clicking here.
Alzheimer's Tennessee: Alzheimer's Tennessee hosts an annual Alzheimer's Management and Reseach Symposium for healthcare providers to learn aobut he latest research and disease management practices for dementia. More information about the conference can be found by clicking here.
Clinical Practice Tool: The Office of Patient Care Advocacy adapted a provider tool from the ACT on Alzheimer's® tools and resources. The tool is designed to serve as a quick reference for providers and other members of the healthcare team, and provide quick Tennessee resources as needed. Click here to access the tool.
Additional training resources can be found on teh NIA website by clicking here.
University Cirriculum: Emory Centers for Training and Technical Assistance offers a free ciriculum for university faculty titiled "A Public Health Approach to Alzheimer's and Other Demenitas." Information about the training guide can be found by clicking here.
CDC Health Brain Initiative (HBI) Roadmap: The Road Map offers state and local public health agencies strategies to influence changes in polocies, systems, and environments related to Alzheimer's and other related dementias. Download the HBI Roadmap here.
TN Dementia Friendly Communities: The Office of Patient Care Advocacy has created a TN Dementia Friendly Community toolkit, building off of successes in other states and communities. The toolkit walks through engaging various sectors of the community to raise awareness about dementia, and support individuals living with the disease and there caregivers. Click here to access the toolkit.
Related Data: There are many data sets avaiable for reference. Click here to learn more about Alzheimer's and other dementias data.
Additional Resources for Public Health:
2019 Healthy Aging Brain Brief Strategies for Action
Healthy Brain Toolkit Supplements:
Webinars Webinar: Brain Health, Cognition and Alzheimer’s Disease
The Offices of Patient Care Advocacy and Chronic Disease Prevention and Health Promotion in collaboration with the Alzheimer’s Association will host a webinar to educate public health professionals about their role in addressing the Alzheimer’s epidemic and to provide opportunities & actions to reduce risk of cognitive decline. This webinar will focus on the intersection of public health and Alzheimer’s and other dementias, linking healthy lifestyles and brain health, and the important role of public health in addressing Alzheimer’s . It will also discuss the newly developed public health toolkit designed to provide community level resources and supports as well as tools to integrate brain health messages into existing public health programming on physical activity, tobacco, obesity, and substance abuse.
The Healthy Brain Initiative’s (HBI) State and Local Public Health Partnerships to Address Dementia, The 2018-2023 Road Map