AAGP Position Statement: Access to Psychiatric Care for Patients with Alzheimer's Disease and Other Dementing Illnesses
Adopted by the AAGP Board of Directors, September 1997
Position: Although Alzheimer's disease (AD) is currently incurable, effective treatments are available for much of the psychiatric morbidity that is commonly associated with the clinical course of AD and other dementias. Treatment of psychiatric morbidity is medically necessary to alleviate patient distress, reduce disability, diminish caregiver burden, delay institutional care, and enhance quality of life. Patients with AD and other dementias should therefore have access to ongoing psychiatric care during the course of their illness; and all health plans and insurers should ensure access to and coverage for psychiatric treatment commensurate with other medical treatments.
Rationale: Alzheimer's Disease and several other dementias are degenerative brain diseases that are progressive over a variable period of up to 15 years. The course and clinical manifestations of these illnesses vary among individuals and over time. In addition to the cognitive morbidity and disability caused by dementia, a substantial proportion of individuals, at some time in the course of their illness, develop comorbid psychiatric problems including depression, delusions, hallucinations, anxiety, agitation and other behavior problems. These morbidities result in patient distress, impaired function and disability; cause caregiver distress and burden; and lead to institutional care and excess utilization of health care resources. Effective treatment is available for some of the cognitive morbidity; and a variety of effective treatments are helpful for much of the psychiatric morbidity. Many of these morbidities can be reduced if promptly recognized, accurately diagnosed, and adequately treated by properly trained professionals. When appropriate and adequate psychiatric treatment is provided, patients' level of distress and dysfunction can be decreased, caregiver distress and burden can be diminished, institutional care can be delayed, quality of life can be improved, and excess utilization of other more costly health care services can be reduced.