Your Dementia Healthcare Team: Their Roles and Areas of Expertise

Whether you’ve recently received a dementia diagnosis or are caring for someone with the condition, it’s important to know who’s who on the dementia care team, their areas of expertise, and what questions to ask when you see them.

Primary Care Provider

PCPs often have established relationships with care partners (spouses, partners, family members, friends, or others who help support people with dementia) and families, so they can work with your circle to coordinate care and make plans. They can also discuss plans for when someone may no longer be able to make decisions on their own.

• “I’ve been noticing [insert symptom here]. Do you think this is a normal change of aging or something more?”
• “What type of testing is available to provide a diagnosis? Can you do it, or do I need to see a specialist?”
• “Are there medications that can help with my symptoms?”
• “Are there lifestyle changes that could improve my memory?”

PCP Referrals

The referral process can be confusing for some and isn’t always the same from one practice to the next. Your PCP might connect you to a new clinician through a direct clinician-to-clinician communication (like in your patient portal, for example).

Alternatively, your PCP might give you a written order (like a prescription) with contact information for the new healthcare professional, plus specific details on what to request. In this case you will likely contact the office on your own.

Neurologist or Neuropsychologist

Altogether, these tests can help determine whether you have dementia and which type you may have. Some neurologists share their findings directly with the person with dementia and their care circle; others might ask your PCP to speak with you. It’s common for a neurologist to make a diagnosis and then allow other clinicians to manage your care.

Questions to ask a neurologist or neuropsychologist include:

• “Which types of tests will help you make the best diagnosis?”
• “Will you share the diagnosis with me or the healthcare provider who referred me to you?”
• “Will you continue to be a part of my healthcare team after today?”

Geriatrician

Questions for your geriatrician include:

• “How is the care you provide different from the care I receive from my PCP?”
• “If I want to continue to see my PCP, am I able to have visits with you, too?”

Geriatric Psychiatrist

• Dementia agitation
• Hallucinations, like seeing or hearing things that aren't there
• Delusions, like fixed beliefs that someone is trying to hurt you or steal from you

Potential questions to ask a geriatric psychiatrist include:

• “What are some strategies to help me manage [agitation, psychosis, irritability, anger, sadness] in the person living with dementia?”
• “What medications are available to help ease [agitation, psychosis, irritability, anger, sadness]?”
• “I’m hesitant to use medications to control symptoms. What other strategies do you recommend?”

Speech-Language Pathologist

Questions to ask an SLP include:

• For care partners, think about the daily tasks that the person living with dementia may struggle with, such as using the remote control, making a phone call, or taking medicine. Ask, “What strategies can I use to help them complete these tasks with less frustration?”

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• “What can I do to [work on or assist my family member with] swallowing at home?”

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• “We’ve heard of swallow studies. What are they? Is this something you would recommend [for me or the person I am caring for]?”

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Occupational Therapist

“Occupational therapists understand how people without dementia tend to complete everyday tasks. That baseline helps us identify changes in thinking from the way someone starts to approach those same tasks once dementia symptoms begin — sometimes before these changes are even noticed by others,” says Danielle Pyle-Godfrey, senior occupational therapist at Grady Memorial Hospital in Atlanta.

Occupational therapists share environmental and task modifications like introducing a cane or walker, making changes to the physical environment, and training family members or care partners to provide the right amount of assistance.

Questions to ask an occupational therapist include:

• “How can I change the environment around the person living with dementia to support their success?”

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• “I’ve noticed a change with [insert self-care activity]. Can you provide tips or strategies to help with this activity?”

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• “Is this cane, walker, or other assistive device really useful for the person living with dementia? Why or why not?”“

Social Worker

Additionally, social workers can help you navigate transitions in the caregiving journey and connect you with others who are living with this disease.

Questions to ask a social worker include:

• “What do you recommend I do to increase support for myself as a care partner?”
• “What health or personal enrichment programs do you recommend for the person living with dementia at this stage of their disease?”
• “What are some safety considerations for my loved one still living in the home?”

The Takeaway

• Dementia diagnosis, care, and treatment takes a village. You may get valuable support from family and friends, but a variety of health professionals should be part of your care team.
• These clinicians may include primary care providers, neurologists or neuropsychologists, geriatricians, geriatric psychiatrists, speech-language pathologists, occupational therapists, and social workers, among others.
• If you need help forming a dementia care team, consider reaching out to your primary care physician, nurse practitioner, or another trusted clinician. They can help you get started with diagnosis and treatment and refer you to other specialists as necessary.