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Development and Implementation of Nonpharmacologic Protocols for the Management of Patients With Alzheimer's Disease and Their Families in a Multiracial Primary Care Setting

Correspondence: Address correspondence to Mary Guerriero Austrom, PhD, Department of Psychiatry, Indiana University School of Medicine, 541 Clinical Dr., CL 590, Indianapolis, IN 46202. E-mail: maustrom{at}iupui.edu

Purpose. Most patients and families with dementia are cared for in primary care clinics. These clinics are seldom designed to provide the necessary comprehensive care. The purpose of this article is to describe nonpharmacologic protocols for the management of patients with Alzheimer's disease and their families that are administered as part of a multifaceted care-management intervention program in a multiracial primary care clinic. Design & Methods. The nonpharmacologic component for the integrated program of collaborative care was developed based on a literature review and previous clinical experience. The care is coordinated by a geriatric nurse practitioner who meets with patients, families, and the primary care physicians. The nonpharmacologic protocols included general educational guidelines about Alzheimer's disease. Specific protocols to treat the common behavioral disturbances associated with Alzheimer's disease also were developed. A major component of the intervention is a monthly psychoeducational support group for caregivers. Results. The intervention has been well accepted by patients, families, and physicians. Approximately one-half of the treatment group has participated in the support group regularly. Implications. The integration of behavioral interventions and team care within the primary care environment has been successful.

Key Words: Behavioral disturbances • Nonpharmacological interventions • Primary care • Minority elderly • Psychosocial-educational support group

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