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  The initial four toolkits (Memory Loss, Urinary Incontinence, Depression, and Falls) were developed for the Practicing Physician Education in Geriatrics project supported by a grant from the John A. Hartford Foundation through the American Geriatrics Society. The MIAH is providing continued support for the ongoing development of new toolkits. The toolkits are intended to help physicians better understand the common 'Geriatric Syndromes' and contain educational materials, suggested guidelines, forms and tools for evaluation, diagnosis and treatment.   American Geriatric SocietyThe John A. Hartford Foundation
Before you access the toolkits, please take a few minutes to go through the mini-tutorial below. It is designed to introduce you to the tools and help you think about how to incorporate them into your practice most effectively. The mini-tutorial is based on the material in the memory loss toolkit.

If you have previously been trained to use the toolkits you can access the toolkits directly.

The Following Mini-Tutorial Covers:
Step 1: The Clinical Process
Step 2: Initial Visit
Step 3: Initial Visit continued
Step 4: Initial Visit Preliminary Diagnostic Assessment
Step 5: First Follow Up Visit

Mini Tutorial Step 1: The Clinical Process
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This mini-tutorial uses the materials from the memory loss toolkit as an example.
The toolkits addressing other topics are similar in basic content and structure.

Four elements are identified in the process of finding the patients with Memory Loss you can help.
Identify: Detect significant memory loss among patients in your practice
Prepare: Improve the quality and efficiency of the diagnostic evaluation
Evaluate: Perform and document a memory disorder evaluation efficiently and with high quality
Follow-up: Offer the likely diagnosis, select drug and nondrug management strategies

Case Study
Mrs. Smith is a 73-year-old woman who came in today for a routine blood pressure follow-up. Her blood pressure was well controlled, and you renewed her prescription for Vasotec. At the end of the day, your office manager came to you to ask if everything was okay with Mrs. Smith because she had difficulty registering for her follow-up apointment.
View 10 Warning Signs of Alzheimer's

Increasing patient awareness
Memory and Aging (View PDF)
Medical Evaluation of Memory Loss (View PDF)

Utilizing cognitive screens during routine visits
Time and Change Test
Temporal Orientation Test

To Prepare Mrs. Smith for a high quality, efficient evaluation, tools are provided to gather the necessary background information for diagnosis and treatment. Click on each one to see what is asked and how Mrs. Smith replied.
Family Report: The Memory Problem (View PDF) - prompts a family informant to tell the story of the decline
Family Report: Medical History (View PDF) - asks patient and family to provide relevant information on past medical history, social history, family history, review of systems
Family Report: Patient Behavior (View PDF) - collects information on patient functional abilities from family member

To Evaluate Mrs. Smith, office staff input the information gathered prior to the visit into the margins of the Memory Loss Evaluation: Initial Visit form. In addition, office staff may administer the cognitive (Folstein MMSE) and depression (GDS) screens. The primary practitioner then:
completes the history
performs and records the physical examination
develops the initial assessment

View Memory Loss Initial Visit Form as filled out for Mrs. Smith (View PDF)

When the evaluation is complete, decisions are required regarding performance of a brain imaging study and referral for specialist evaluations. Educational Materials included in the Toolkits may be helpful for patients, such as:
Brain Imaging (View PDF)
Specialists in Memory Loss (View PDF)

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