Dementia and Diversity in Primary Care: A Primer - Guidelines, Ethnic Differences, and Assessment

Dementia and Diversity in Primary Care: A Primer - Guidelines, Ethnic Differences, and Assessment

Internet Enduring Material Sponsored by:

Stanford University School of Medicine

Presented by:

Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine

Course Description

Although dementia is the most common diagnosis in older adulthood it is under-recognized in primary care. This gap in recognition is even greater for patients, their caregivers and families who belong to various ethnic and racial minority populations. As U.S. residents are aging, and becoming more racially and ethnically diverse, physicians and other healthcare providers will increasingly need to tailor their care to specific populations. This series of continuing education activities is designed to help healthcare providers recognize dementia, select culturally appropriate assessment tools, and communicate effectively about dementia care in ethnically and racially diverse populations. This initial course, Dementia and Diversity in Primary Care: A Primer - Guidelines, Ethnic Differences, and Assessment, will introduce primary care physicians and members of their care teams to the “ethnogeriatric imperative” and its impact on dementia. Future courses will provide information on assessing and caring for diverse racial and ethnic groups.

Intended Audience

This course is designed for physicians in primary care, family practice, internal medicine and psychiatry specialties and nurses and social workers who work with older people. 

Dates, Duration & Fee

• Release Date: November 25, 2015
• Expiration Date: November 27, 2017
• Estimated Time to Complete: 1.5 Hours
• CME Credits Offered: 1.50
• Registration Fee: FREE

Please review all of the information on this page before clicking the Courseware tab at the top of the page to begin the course.

To Obtain CME Credits

• Review the information below and complete the entire activity.
• Complete the CME Post-test, CME Evaluation Survey, and CME Activity Completion Statement at the end of the activity.
• You must receive a score of 75% or higher on the CME post-test in order to receive a certificate. You will have two attempts to answer each multiple-choice question (or one attempt for questions with only two options) to pass the post-test.
• Once you attest to completing the entire online activity and have scored 75% or higher on the post-test, your certificate will be generated automatically and will be available on your Dashboard page.
• Physicians will be awarded AMA PRA Category 1 Credits™. All other participants will receive a Certificate of Participation.

Learning Objectives

At the conclusion of this activity, participants should be able to:

• Compare the risk of developing Alzheimer’s disease in racial and ethnic minorities to the general population.
• Identify the barriers faced by ethnic/racial minorities in obtaining diagnosis and services after onset of dementia.
• Identify dementia in older adults from diverse race/ethnic backgrounds.

Table of Contents

1. Introduction
2. Overview of Dementia and Ethnicity
3. Diagnostic Guidelines for Neurocognitive Disorders
4. Overview of Dementia Care for Primary Care Providers
5. Literature Regarding Ethnic Differences in Dementia Treatment
6. Dementia Assessment for Primary Care Providers
7. Diagnosis and Treatment of Dementia for Primary Care Providers 
8. Course Wrap-Up 
9. Resources and References
10. Help! 

Disclosures

The following planners, speakers and authors have indicated that they have no relationships with industry to disclose relative to the content of this activity:

Nancy Morioka-Douglas, MD, MPH 
Clinical Professor, General Medicine Disciplines
Stanford University School of Medicine
Medical Director for Patient Centered Care in Primary Care, Stanford Health Care
Co-Director, Stanford Geriatric Education Center 
Course Director
Speaker

Dolores Gallagher-Thompson, PhD, ABPP 
Professor of Research, Department of Psychiatry and Behavioral Sciences
Director, Stanford Geriatric Education Center 
Stanford University School of Medicine
Co-Course Director
Speaker

Nusha Askari, PhD  
Program Manager
Department of Psychiatry/Public Mental Health & Population Sciences 
Stanford University School of Medicine
Planner

Kala Mehta, DSC, MPH
Associate Professor
Department of Epidemiology and Biostatistics, University of California, San Francisco
Program Evaluation Consultant, Stanford Geriatric Education Center 
Stanford University School of Medicine
Planner

Yuan Marian Tzuang, MSW 
Program Coordinator, Stanford Geriatric Education Center 
Stanford University School of Medicine 
Planner

Annecy Majoros, BA
Research Assistant
Department of Psychiatry/Public Mental Health & Population Sciences
Program Assistant
Department of Medicine/General Internal Medicine
Stanford University School of Medicine
Planner

Gwen Yeo, PhD, AGSF 
Director Emerita, Stanford Geriatric Education Center
Stanford University School of Medicine 
Speaker

Michael D. Greicius, MD, MPH  
Associate Professor, Department of Neurology & Neurological Science 
Associate Professor (by courtesy), Department of Psychiatry and Behavioral Science
Stanford University School of Medicine 
Speaker

Technical Design and Development

Mike McAuliffe
Stanford EdTech 

Greg Bruhns
Stanford Online

Jim Neighbours 
Stanford Center for CME

Jenny Xu
SGEC Instructional Designer

Hardware/Software Requirements

• Computer with Internet connection
• Current version of Chrome, Firefox or Safari browser. You must have javascript enabled.

Accreditation and Designation of Credits

The Stanford University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Stanford University School of Medicine designates this enduring material for a maximum of 1.50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The California Board of Registered Nursing recognizes that Continuing Medical Education (CME) is acceptable for meeting RN continuing education requirements as long as the course is certified for AMA PRA Category 1 Credits™ (rn.ca.gov). Nurses will receive a Certificate of Participation following this activity that may be used for license renewal.

Commercial Support Acknowledgement

This activity received no commercial support.

Cultural and Linguistic Competency

California Assembly Bill 1195 requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. It is the intent of the bill, which went into effect July 1, 2006, to encourage physicians and surgeons, CME providers in the State of California and the Accreditation Council for Continuing Medical Education to meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development. The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area. The Stanford University School of Medicine Multicultural Health Portal also contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws. You are encouraged to visit the portal: http://lane.stanford.edu/portals/cultural.html

CME Privacy Policy

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Contact Information

If you are having technical problems (video freezes or is unplayable, can't print your certificate, etc.) you can submit a Help Request to the OpenEdX Team. If you have questions related to CME credit, requirements (Pre-test, Post-test, Evaluation, Attestation) or course content, you can contact the CME Online support team at cmeonline@stanford.edu

Bibliography

Braun KL, Takamura JC, Mougeot T. Perceptions of dementia, caregiving and help-seeking among Vietnamese immigrants. J Cross Cult Gerontol. 1996;11(3):213-28.

CALD Dementia Strategic Model. (2008). Australia.

DiGregorio M, Salemink O. Living with the dead: The politics of ritual and remembrance in contemporary Vietnam. Journal of Southeast Asian Studies. 2007;38(3):433-440.

Hinton L. Improving care for ethnic minority elderly and their family caregivers across the spectrum of dementia severity. Alzheimer Disease and Associated Disorders. 2002;16(Suppl 2):S50-S55.

Hinton L, Franz C, Yeo G, Levkoff S. Conceptions of dementia in a multi-ethnic sample of family caregivers. J Am Geriatr Soc. 2005;53(8):1405-10. 

Hinton L, Levkoff SA, Fox K. Introduction: exploring the relationships among aging, ethnicity, and family dementia caregiving. Cult Med Psychiatry. 1999;23(4):403-13. 

Hinton L, Tran JNU, Tran C, Hinton D. Religious and Spiritual Dimensions of the Vietnamese Dementia Caregiving Experience. Hallym Int J Aging HIJA. 2008;10(2):139-160. 

Phan T, Silove D. An overview of indigenous descriptions of mental phenomena and the range of traditional healing practices amongst the Vietnamese. Transcultural Psychiatry. 1999;36(1):79–94. 

Samton JB, Ferrando SJ, Sanelli P, Karimi S, Raiteri V, and Barnhill, JW. The clock drawing test: diagnostic, functional, and neuroimaging correlates in older medically ill adults. J Neuropsychiatry Clin Neurosci. 2005;17(4):533-40. 

Schipper, KM. The Taoist Body. Berkeley, CA: University of California Press, 1993 

Timberlake EM, Cook KO. Social work and the Vietnamese refugee. Social Work. 1984;29(2):108-113. 

Tran JNU, Yeo G. Older Vietnamese Americans. In: Adler RN, Kamel HK, eds. Doorway Thoughts: Cross-cultural Health Care for Older Adults. Boston, MA: Jones & Bartlett, 2004. 

U.S. Census Bureau (2001). The Asian and Pacific Islander Population in the United States: March 2000. Retrieved from http://www.census.gov/population/www/socdemo/race/api.html. 

Yeo G, Tran JNU, Hikoyeda N, Hinton L. Conceptions of dementia among Vietnamese American caregivers. Journal of Gerontological Soical Work. 2001;36(1-2):131-52. 

Yeo G, Gallagher-Thompson D. (eds). Ethnicity and the Dementias. New York, NY: Routledge, 2006.

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