What is it like to get a dementia diagnosis from an interdisciplinary team?

Are you thinking about getting a more in-depth dementia diagnosis for yourself or a loved one? If you aren’t, you may want to consider it. I visited University of Pittsburgh’s Montefiore Hospital and did a two-day observation of their interdisciplinary team’s diagnosis process. The Alzheimer’s Disease Research Center (ADRC) is a fantastic place to go to learn about dementia. Six years ago, I interned at the Penn Memory Center at Penn Medicine in Philadelphia, PA. They have a similar program. Here’s what you’ll encounter when looking for a better, more complete, diagnosis than one you’d get from a family physician. 

There should be between two and three people attending the diagnosis process for this half-day experience. One should be the person with a potential dementia, and the other one or two should be close friends, a family member, or spouse. 

If you are the person who may have dementia…

1. A social worker will see you to do an intake and ask a couple questions. 
2. You’ll complete a blood draw with a nurse or physician.
3. A psychiatrist will see you to complete a self-assessment questionnaire about your past and current lifestyle. They’ll ask you questions about your family, your hobbies, and your feelings on life.
4. A physician assistant, nurse, or physician will see you and do both a mini mental and larger physical exam. They may ask you questions like, “How many quarters are in a two dollars?” The physical exam will test your reflexes, blood pressure, and strength.
5. A physician will probably join you all in the exam room and complete a few more physical tests.
6. You’ll do a gait test with someone from the team. They’ll assess your walk and your strength if they pull or push your body slightly.
7. The team will ask if you’ve already had an MRI, and if you haven’t had one, they’ll set it up for another day. They need your brain scan to complete the screening process.
8. You’ll be seen by a psychometric tester, who will test your memory and cognitive functions with written, drawn, and spoken exams. This could take up to an hour and a half, and tends to be the longest part of the day.
9. Once you are done, and the MRI comes in, the team will get together (usually a few weeks later) and discuss your case. They’ll come up with a diagnosis by using an interdisciplinary approach.

If you are the family member(s)…

1. A social worker will see you and ask a lot of in-depth questions about you and the person with dementia. They’ll ask about your family history, their family history, your relationship, and age of potential dementia onset. Be prepared that some of these questions could be stressful, depending on your relationship with the person who has dementia.
2. You will also see the psychiatrist. They’ll ask about the person’s change in condition, their background, their mood, and their level of insight into their own condition.
3. The nurse practitioner or physician assistant will sort through their medications, so make sure you bring all of their pill bottles in whatever condition they are in. They will probably ask you a few questions, as well.
4. You may meet with another team member who will talk to you about resources and support groups in the area.

The whole process can take about half a workday, so be prepared to spend some time there. The team will call you to come back when they have an interdisciplinary diagnosis. 

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