What do we do:
The Diagnostic Unit is a service aimed to make a diagnosis on time, provide appropriate treatment and follow up people with cognitive disorders and dementias.
Dr. Mercè Boada
Mercè Boada is founder and medical director of Fundación ACE. The Government of Catalonia recognized her in 2016 with the St. George's Cross distinction for her contribution to the field of dementia and research.
Her focus in research is on the treatment of Alzheimer's disease and related dementias, especially on the genotype and phenotype of common degenerative diseases and the design of new pharmacological and non-pharmacological treatments.
Diagnosis is obtained through an interdisciplinary process that includes five visits to make the integral assessment and the design of intervention proposals, which contemplate the needs of the person globally.
The multidisciplinary team, with the capacity to carry out the specific evaluation activities, is made up of personnel specialized in medicine, neurology, geriatrics or psychiatry, in neuropsychology, in nursing and in social work.
How do we do it?
Diagnosis is obtained through an interdisciplinary process to assess together the cognitive, psychological, physical and social aspects.
Social work interview
Diagnostic consensus meeting and establishment of the intervention plan
Communication of the diagnosis
Once the user has the diagnosis, a personalized follow-up plan is proposed that combines visits to primary care and visits to the Diagnostic Unit of Fundació ACE.
Follow-up visits consist of specialized assessment and follow-up by a doctor, a psychologist or a social worker, depending on the reason for the consultation.
To guarantee a good communication, the possibility of contacting the neurologist, geriatrician or social worker of reference is offered. This service can deal with questions of medication or issues related to legal procedures to request State aid.
This protocol allows to solve crisis situations when it is necessary, or to provide the precise information at the moment of the request.
To offer this service 7 neurologists, 1 geriatrician and 3 social workers dedicate part of their working time to answering these questions via telephone, email or in person.
SUPPORT AND TRAINING GROUPS
Support groups are aimed at relatives and caregivers of people with cognitive impairment or dementia, with the aim of providing support, training and accompaniment. Groups are led by specialists in dementia, psychologists and social workers.
Every session deals with issues related to the theoretical and practical aspects of the dementia process.
Its aims are:
- Offer comprehensive training on the disease, with the aim of providing tools and strategies to competently address the needs (both objective and subjective) that appear in the care of the person with dementia.
- Teach relatives and caregivers skills to intervene succesfully in the increase of the dependence the disease has.
- Give strategies to redirect behaviour.
- Train reduction techniques and how to cope with the overload of the caregiver.
- Provide support and the oportunity to share emotions difficulties, problems and ideas through the group experience.
Nowadays, we have:
- A group for spouses of people with pre-senile dementia (which means people under 65 years old with dementia)
- A group aimed at sons and daughters of people with pre-senile dementia.
- A post-diagnosis training group aimed at relatives of people who have been recently diagnosed.
The intervention of the Social Work Department in the diagnosis process aims to know the degree of insertion of the person evaluated, in its socio-familiar context.
The neurological and neuropsychological evaluations are indicators from which the type of care and attention that the person needs can be inferred.
This information together with the social and family study carried out by the social worker, makes it possible to determine the demands that may arise in the care of the person and to design the most appropriate intervention plan.
If the person is diagnosed with mild cognitive impairment, the social follow-up is done directly with her. If, on the contrary, the person is diagnosed with dementia, the follow-up will be done with the family or the main caregivers to accompany them throughout the process.
The neuropsychological exploration intervenes in the diagnostic process to globally evaluate the cognition of the person, both emotional and behavioral.
To perform this evaluation, we use our own neuropsychological battery (NBACE). This battery, which is validated, explores the different cognitive domains (language, memory, orientation ...) that intervene in the process of dementia. This exhaustive exploration lasts 45 minutes.
In addition, Fundació ACE facilitates that anyone over 50 years old can request a free memory check to know their cognitive performance.
The "Open House" initiative we launched in 2008, has already evaluated more than 3,000 people, completely free of charge and without a family doctor's referral.
To participate, you only need to register at 93 430 47 20 or by sending an email to firstname.lastname@example.org.
NEUROLOGY AND GERIATRICS
Within the assistance area, represented by the Diagnostic Unit, the challenge for neurologists is to identify and diagnose as soon as possible people who have or will develop cognitive impairment.
Our medical team is formed by qualified and experienced neurologists and geriatricians specialized in the treatment of people with dementia. The geriatricians usually assess elderly people in whom cognitive impairment may be related to other pathologies.
In the diagnostic process, after the visit with social work, the clinical interview is carried out. It is a visit where the family presents the medical history and the reason for the consultation to the doctor. It is a meeting that serves the neurologist or geriatrician to relate the symptoms detected by the family, which despite can be denied or ignored by the evaluated person, are obvious for those who live with it.
Secondly, the neurological examination is the intervention in which the professional examines the person in order to evaluate the signs and symptoms and relate them to the data obtained in the previous visit.
Finally, in the diagnostic consensus session, all the case data obtained during the process is provided to establish a diagnosis of consensus and a type of treatment, lifestyle and preventions recommendations as well as social support.