Established Dementia

The approach to established dementia is to maintain the patient's functional status, treat reversible causes of memory impairment, and avoid polypharmacy. Support for caregivers is also important as dementia can be more distressing for caregivers than the patient themselves.

6 Cognitive Domains (DSM-V Neurocog Disorders Criteria)







Treatment History
Current outpatient neurologist: _______
Date of last outpatient visit: _______
Date of diagnosis: _______
Type of dementia











Previous dementia medications tried












Current dementia medication regimen













Medication Side Effects Experienced













Functional Status
Where does the patient currently reside: _______


Who assists the patient with ADLs (family, health aide, etc.): _______






Workup for treatable causes of Memory Impairment








Other Previous Workup





Back to home