AMDCP Credit Designation: This session has been approved for a total of 1.5 Clinical credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).
The American Medical Directors Association designates this educational activity fora maximum of 1.5 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity. Presenter(s): Patricia L. Bach, PsyD, RN; Daniel A. Bluestein, MD, CMD Disclosure(s): All presenters reported they had no relevant financial relationships to disclose. Session Description: This session presents an overview of two neurobehavioral instruments, the Neuropsychiatric Inventory (NPI) and the Clinical Dementia Rating Scale (CDR), utilized in the definitive diagnosis of dementia. Together,they identify dementia severity based on cognitive and functional performance,as well as neuropsychiatric disturbances commonly seen in dementia. Although these instruments incur little cost, are easily used, and yield significant psychiatric, behavioral, and functional information, they are infrequently utilized in the long term care setting. The workshop is designed to provide a comprehensive didactic overview and samples of these instruments, interactive exercises based on actual cases, and suggestions for cross-training long term care staff in the use of these instruments. Learning Objectives:
Describe two neurobehavioral assessment instruments (NPI and CDR)used in diagnostic assessment of dementia
Identify neuropsychiatric symptoms and level of dementia severityusing neurobehavioral assessment instruments
Identify web-based resources for use of both the NPI and CDR in thelong term care setting
Discuss manner in which neurobehavioral assessment instruments may beused in participant practices
Use neurobehavioral assessment instruments through interactive exercise designed by presenters
References: Briesacher, B.A., et al., The Quality of Antipsychotic DrugPrescribing in Nursing Homes. Archives of Internal Medicine, 2005. 165: p.1280-1285. Franco K. N., M.-R.B., Pharmacological Treatment ofNeuropsychiatric Symptoms of Dementia: A Review of the Evidence. Journal of theAmerican Medical Directors Association, 2006. 7(3): p. 135-202. Schneider, L.S., et al., Effectiveness of atypicalantipsychotic drugs in patients with Alzheimer's disease. NEngl J Med, 2006. 355(15): p. 1525-38. Wall Street Journal article Prescription Abuse Seen in U.S.Nursing Homes. Retrieved on March 1, 2008 fromhttp://online.wsj.com/article/SB119672919018312521.html?mod=hpp_us_pageone. FDA Public Health Advisory Deaths with Antipsychotics inElderly Patients with Behavioral Disturbances. Retrieved on March 10, 2008 fromhttp://www.fda.gov/cder/drug/advisory/antipsychotics.htm. Rosenheck, R.A., et al., Cost-Benefit Analysis ofSecond-Generation Antipsychotics and Placebo in a Randomized Trial of theTreatment of Psychosis and Aggression in Alzheimer Disease. Arch GenPsychiatry, 2007. 64(11): p. 1259-1268. Agency for Healthcare Research and Quality. Off-Label Use ofAtypical Antipsychotic Drugs. Retrieved on March 10, 2008 fromhttp://effectivehealthcare.ahr...
Eastern Virginia Medical School