![]() 1, 2 For example, if the patient does actually have AD, a trial of a cholinesterase inhibitor may be started right away. Doing the screening as early as possible in the disease process may help the patient significantly. The psychiatrist may also want to screen the patient for AD if a patient’s loved ones report that the patient’s behavior has recently changed. When a patient presents to the psychiatrist with concerns of poor memory, the psychiatrist may want to screen the patient formally for AD. ![]() In this article, I discuss five treatment initiatives in the order in which they tend to arise during the illness progression of a patient with AD: screening for AD, providing information to patients on nonevidence-based treatments of AD, assisting patients with contacting loved ones as the disease progresses, confronting patients with difficult decisions, and discussing moral concerns of the patient with his or her loved ones. In other words, the psychiatrist may be the only person in the patient’s life who is trusted enough to approach certain difficult issues with the patient, such as the need to discontinue driving a car or move into a nursing home. ![]() These initiatives may be particularly important if the psychiatrist has an established, trusting relationship with the patient or the patient’s loved ones, because the psychiatrist may be the only care provider who is able to “successfully” carry out certain tasks. When a psychiatrist treats a patient with Alzheimer’s disease (AD), there are several treatment initiatives the psychiatrist should consider. ![]()
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