Limited time, limited reimbursement, and other health care barriers may lead to challenges when treating dementia patients, according to a study by the NIA-funded Alzheimer’s Disease Research Center at the University of California, San Francisco. These findings, published in the November 2007 issue of the Journal of General Internal Medicine, are based on open-ended interviews with 40 primary care physicians in Northern California. Recurring themes arising in at least 25 percent of the interviews included insufficient time, difficulty accessing and communicating with specialists, low reimbursement for certain services, and poor connections with community social service agencies.
The findings suggest that practice constraints may lead to delayed detection of behavioral problems, reactive rather than proactive dementia management, and reliance on pharmacological rather than psychosocial approaches to care. The researchers conclude that more effective educational interventions for families and physicians and structural practice changes are needed to better meet the needs of people with dementia and their families.