Dementia
We provide comprehensive dementia care for Veterans with a loss of cognitive functions.
Dementia health care
Our mission is to improve the lives of Veterans and their families with diagnosis, medication management and connection to social supports. We partner with the Geriatric Research Education and Clinical Center (GRECC) to integrate care, outreach, research and education. Treatment plans are developed in partnership with patients and families to meet patient goals.
Health care services
Medical and support team
Your care team may include:
- Primary care provider: Screens for and does initial assessment of cognitive concerns, may order diagnostic work up and/or place referrals for assessment by a specialist, may manage dementia treatment.
- Geriatrician: Primary care provider that specializes in the care of older adults.
- Neurologist: Doctor that specializes in the diagnosis and management of diseases affecting the brain and nervous system, including dementia.
- Geriatric psychiatrist: Psychiatrist with additional specialized training in mental health issues affecting older adults, including dementia.
- Neuropsychologist: Psychologist with specialty training in assessing cognitive/thinking abilities like memory, attention, language and problem-solving skills to assist with diagnosis and treatment recommendations.
- Social worker: Helps patients and caregivers find supportive services and navigate long-term care planning.
- Pharmacist: Assesses for medications that could be affecting thinking abilities.
- Occupational therapy/physical therapy/speech therapy/nursing: Assess impacts of dementia on daily functioning and help develop non-medication interventions to support patients and caregivers.
- VA Caregiver Support Program: For caregivers of eligible and covered Veterans enrolled in the VA healthcare system. The program’s mission is to promote the health and well-being of family caregivers through education, resources, support, and services. Learn more about the Minneapolis VA Caregiver Support Program.
Diagnostic services
Your evaluation will start with a provider visit and the following care services may be considered:
- Specialist referral (e.g., geriatrician, neurologist, geriatric psychiatrist): For more challenging diagnostic or management questions.
- Cognitive screening: Brief screening tools that detect possible cognitive impairment and need for further assessment.
- Neuropsychological testing: More in-depth evaluation of a person’s thinking abilities performed and analyzed by specially trained neuropsychologists.
- Occupational therapy: Evaluation of how thinking problems are impacting a person’s daily functioning (e.g., ability to safely drive, manage finances and medications, etc.).
- Brain imaging (MRI or CT): Primarily used to rule out conditions such as tumors or strokes. They do NOT confirm diagnoses such as Alzheimer’s disease, though sometimes can provide clues (e.g., if certain brain structures look more shrunken than normal).
- Lab tests: To rule out certain medical problems that could be contributing to cognitive/thinking problems.
- Sleep medicine specialist referral: To evaluate for sleep disorders (e.g., sleep apnea) that may be contributing to cognitive/thinking problems.
Preparing for your clinic appointment
Prepare for your appointment
- Please bring a family member, friend or caregiver with you, preferably someone that knows you well. Make a list of your concerns and prioritize them.
- Bring a list of your medications and the dosage you are taking.
- Bring a list of medications you have tried and the reasons you were taken off them.
- Don’t be afraid to ask questions or for clarification.
- Bring any prior outside records with you:
- Head or brain imaging (disc with images and report)
- Cognitive assessments (e.g., neuropsych testing reports)
- Neurology records
- Any other records that apply to your memory symptoms
Additional resources to help you prepare
Visiting Your Doctor - Alzheimer's Association
Effective communication with your doctor is important when you are seeking a diagnosis for memory loss.
Working With the Doctor - Alzheimer's Association
Good health care requires a partnership between the patient, family and physician.
When to contact your primary care provider
If you or someone you know has concerns about memory, contact your primary care provider to request a cognitive screening test.
Warning signs
- Difficulty completing familiar tasks
- Difficulty problem-solving
- Confusion about time or place
- Getting lost
- Misplacing items
- Personality or mood changes
- New problems with writing, words or speaking
Review the Alzheimer's Association page "10 Early Signs and Symptoms of Alzheimer's and Dementia"
See the doctor right away if a person with dementia...
- Is suddenly more confused
- Has a major change in memory or mood
- Faints or falls
- Is suddenly unable to speak or move part of the body
- Has a fever
- Is suddenly incontinent ("having accidents" or wetting the bed)
Education: dementia, Alzheimer’s and neurocognitive disorders
What is mild cognitive impairment?
“Some people have more memory problems than other people their age. This condition is called mild cognitive impairment, or MCI. People with MCI can take care of themselves and do their normal activities." From the National Library of Medicine – Mild Cognitive Impairment
MCI may also be referred to as “mild neurocognitive disorder”.
MCI is important to identify because some causes (e.g., sleep disorders, certain medications) can be managed or reversed. MCI can also be an early sign of Alzheimer’s disease or other causes of dementia.
What is Dementia?
“Dementia is a loss of mental functions that is severe enough to affect your daily life and activities. These functions include:
- Memory
- Language skills
- Visual perception (your ability to make sense of what you see)
- Problem solving
- Trouble with everyday tasks
- The ability to focus and pay attention”
From the National Library of Medicine – Dementia
Dementia may also be referred to as “major neurocognitive disorder”.
Dementia is an umbrella term used to describe a range of neurological conditions affecting the brain that get worse over time. Most types of dementia are neurodegenerative disorders which result in a progressive and irreversible loss of neurons and brain functioning. Currently, there are no cures for these diseases.
Behavioral and psychological symptoms
A person diagnosed with dementia may experience a range of behavioral and psychiatric symptoms. These symptoms can occur across at all stages of dementia are often a normal response to stress or unmet needs.
Behavioral symptoms may have significant impact on a person’s independence in daily life and their relationships. These symptoms are also associated with greater morbidity and mortality, increased caregiver burden, and early nursing home placement.
Taking care of a person who experiences these symptoms both in the home and in a care facility requires a patient- and caregiver-centered approach during the development of an appropriate treatment plan.
Education resource: Treatments for Behavior - Alzheimer's Association
Physically non-aggressive behaviors
- Inappropriate dressing or disrobing
- Inappropriate eating or drinking
- Strange handling of objects
- Hiding things
- Wandering
Physically aggressive behaviors
- Biting
- Hitting
- Grabbing
- Hitting
- Kicking
- Spitting
- Tearing things
- Throwing things
Verbally non-aggressive behaviors
- Complaining
- Repetitive sentences and questions, fixating on certain topics
Verbally aggressive behaviors
- Yelling
- Cursing
- Verbal threats
Other symptoms
- Inappropriate social or sexual behaviors including verbal or physical advances, exhibitionism and public masturbation
- Psychosis, delusions and hallucinations
- Increased activity
- Changes in mood including apathy, anxiety and depression
Dementia resources
Alzheimer’s Association
The Alzheimer's Association is the leading voluntary health organization in Alzheimer's care, support and research.
- 10 Early Signs and Symptoms of Alzheimer's and Dementia - Alzheimer's Association
- Education Center - Alzheimer’s Association
Caregiver Resources - VA Caregiver Support Program
Resources on various Veteran Caregiver topics.
The Association for Frontotemporal Degeneration
Frontotemporal degeneration is the most common form of dementia for people under age 60.
Lewy Body Dementia Association
Through outreach, education and research, we support those affected by Lewy body dementias, their families and caregivers.
Resources - VHA Office of Rural Health
Rural Veterans have distinct challenges compared to their urban counterparts. This is a list of resources to connect you to the support and services required to support your long-term health and well-being.
Dementia safety
Safety resources
Driving safety
Driving and other safety concerns - VA Geriatrics and Extended Care
Driving ability is a complex task that may be impaired by certain health conditions.
Firearm safety
Lethal Means Safety & Suicide Prevention - VA REACH
Though it may seem like a small barrier, securing your guns with a simple lock puts space between the thought and the trigger.
If you own a firearm, or live in a household where there are firearms, the following information can help keep you and those around you safe.
Advanced planning resources
General
Starting the Conversation about Health, Legal, Financial and End-of-Life Issues - Eldercare Locator
For older adults, families and close friends these conversations may be tough to initiate, but they are valuable and necessary for all involved.
Making Decisions: Advance Care Planning - VA Geriatrics and Extended Care
Advance care planning is a process of clarifying your values and health care choices for use at a future time if you are no longer able to make decisions for yourself.
Financial
Money Matters - Alzheimer’s Association
The sooner planning begins, the more the person with dementia may be able to participate in decision-making.
Honoring patient's wishes
POLST (Physician’s Orders for Life-Sustaining Treatment)
National POLST form and guide.