When someone you love is diagnosed with Alzheimer's disease or another form of dementia, worrying about what lies ahead can be overwhelming. On top of that, you're suddenly thrust into a world of new medical terms and information while you're planning for their long-term care in your home or a memory care center.
Creating a comprehensive dementia care plan with your loved one, their doctor and their specialist or health care clinician can help you navigate this unfamiliar health care landscape. A care plan can help you understand the stage of your loved one's dementia, what to expect as their condition progresses and how to better care for them.
What Is a Dementia Care Plan?
A dementia care plan usually includes steps to address functional limitations and treating anxiety, depression and other symptoms discovered during an assessment. The care plan will also include referrals to community resources such as adult day care programs, rehabilitation services, educational resources and support groups.
A physician, nurse practitioner, clinical nurse specialist or physician assistant can help you create a care plan based on a full review of the patient. Cognitive assessment and dementia care services — which are covered by Medicare — are available to people who are cognitively impaired, including people diagnosed with Alzheimer's disease and other dementias. Someone without a clinical diagnosis of dementia can receive dementia care services if their doctor determines that they're cognitively impaired.
A dementia care plan typically includes an interview with a family member or caregiver who can provide an accurate history of the patient, the progression of their dementia and their current symptoms or issues. During the care plan evaluation, a health care practitioner typically spends at least an hour face to face with the patient and their caregiver.
Where Does a Cognitive Assessment Fit In?
A cognitive assessment is a major part of creating a dementia care plan for a patient. Each aspect of the assessment helps you and the clinician understand what kind of care your loved one needs, and how much of it.
According to Medicare, a cognitive assessment includes:
- Examining the patient to observe their cognition and evaluate their medical decision-making abilities.
- Assessing how the patient performs basic activities of daily living, such as personal hygiene and grooming, dressing, toileting, mobility and eating.
- Testing for stage and rating of dementia, from mild (functioning is starting to be affected) to severe (depends completely on others for basic daily activities).
- Reviewing and reconciling high-risk medications.
- Evaluating neuropsychiatric and behavioral symptoms, such as sleep disturbance, depression and anxiety.
- Conducting a safety evaluation for home and for driving a vehicle.
- Identifying available social systems.
- Assessing caregiver knowledge and willingness to provide care.
- Creating a written care plan and addressing advance care planning, including palliative care needs.
The exam and assessment might take place in one visit or across several visits, depending on the complexity of the patient's needs. An assessment and evaluation can take place in a clinical office, an outpatient setting, the patient's home or at a residential setting, such as a skilled nursing facility.
Medicare Part B covers the cost of creating a care plan (minus the deductible and co-pay), and the plan needs to be updated as the patient's dementia progresses. However, a health care provider can only submit a care plan claim to Medicare once every 180 days.
What Happens Next?
Once the health care practitioner creates a dementia care plan, the clinician shares the written plan with the patient and their caregiver.
If your loved one has Medicare Part B, you won't have to worry about spending a lot of money on creating a care plan. Their medical insurance covers the cost of the visit, minus the Part B deductible and 20% co-pay.
Creating a dementia care plan for a loved one with dementia or Alzheimer's disease is a crucial step in assuring they receive proper care. Want to learn more? Download the Alzheimer's Association's guide to cognitive assessment and care-planning services, then make an appointment with your loved one's doctor to create a care plan.