Editorials

Care plans for people with Alzheimer’s disease

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c2626 (Published 03 June 2010) Cite this as: BMJ 2010;340:c2626
  1. Lon S Schneider, professor of psychiatry, neurology, and gerontology
  1. 1University of Southern California Keck School of Medicine, 1510 San Pablo St, HCC 600, Los Angeles, California, 90033, USA
  1. lschneid{at}usc.edu

    Intuitively a good idea, but hard to prove they are effective in practice

    In the linked cluster randomised trial (doi:10.1136/bmj.c2466), Nourhashemi and colleagues tested a specific care plan for patients with Alzheimer’s disease to determine whether it improved activities of daily living and delayed admission to institutional care or death.1 The authors randomised specialty memory clinics in France to provide patients with the usual care given at the clinic or a special dementia care plan, which consisted of twice yearly assessments based around a checklist and clinician initiated interventions as needed. The checklist assessed each patient’s and caregiver’s knowledge of the illness; the caregiver’s health; the need for home help and respite care; the patient’s nutritional status, functional dependency, gait, need for exercise training, behavioural symptoms, depression status, sleeping pattern, and car driving risk; any legal issues; and the decision to admit to institutional care. The interventions consisted mainly of low intensity verbal or written education and counselling for the caregiver and patient and conveying recommendations to the patient’s primary care practitioner. The trial found …

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