Dementia Care Coordination Program
This is a consultative service that provides clinical care and education to Veterans, families, and providers regarding the diagnosis of dementia, the disease process, and the associated social, behavioral, and cognitive changes. We are not a primary care service (PACT) but a specialty service that offers additional support and recommendations. We are an interdisciplinary team that includes Geriatricians, a Clinical Nurse, and a Social Worker.
Dementia Care Coordination Program
• Consultative service that provides clinical care and education to Veterans, families, and providers regarding the diagnosis of dementia, the disease process, and the associated social, behavioral, and cognitive changes
• Not a primary care service (PACT) but a specialty service that offers additional support and recommendations.
• An interdisciplinary team that includes Geriatricians, a Clinical Nurse, and a Social Worker.
Mission
To provide support to our Veterans with dementia and their caregivers/care partners residing in the community by assisting them through education or assisting them in developing a proactive dementia care plan that is patient centered.
How do I know if I’m eligible?
Dementia Care Coordination is part of Cincinnati VA Health Care System. A Veteran must be enrolled in VA care and seeing a Primary Care Provider within the Cincinnati VA Medical Center. A co-payment may apply if you normally are charged a co-payment for outpatient visits based on your VA eligibility group.
Services
The Dementia Care Coordinator is a Social Worker and Registered Nurse who work together in providing supportive interventions including:
- Educational resources regarding the diagnosis of dementia and disease progression
- Help problem solve around social, behavioral, personality, functional and mental health needs that affect daily living
- Care planning around dementia care management at home and caregiver strategies
- Connect with Caregiver support team
- Support in talking and planning with your VA providers to coordinate VA care.
- Assistance with transitions of care, short term goals and long-term care planning
- Face to Face, Telephone and VA Video Connect (VVC) support available by appointment.
- Information and referrals to both VA and community resources.
- VA Partners with the Alzheimer’s Association®
Contact their 24/7 Helpline: 1-
Contacts
- For more information about the Dementia Care Coordination program, please contact us at
or . - Request referral through your Cincinnati VA Health Care System Primary Care Team.
- Primary care call center- Toll free:
- Direct:
- Primary care call center- Toll free:
Dementia Care Resource Guide