Home-based multidisciplinary diagnosis and treatment of inner-city elders with dementia

The Memory and Aging Project Satellite (MAPS) of the Washington University Alzheimer's Disease Research Center was developed to meet the medical, soci al, and housing needs of minority and medically underserved elders with cog nitive impairments. MAPS is located in the offices of the St. Louis Area Ag ency on Aging (AAA). This program provides multidisciplinary outreach, as w ell as home-based diagnosis, treatment, and case management. It differs fro m most other satellite programs in that it seeks to provide service to indi viduals who do not voluntarily seek help for dementia. Cognitively impaired clients had numerous, unmanaged medical conditions and social problems. Fe w clients were adequately served by health and social service systems. Desp ite recent contact, only 10% of clients received a formal diagnosis of deme ntia from a physician. Treatment was hampered by the absence or limitations of caregivers. Despite the complexities of these cases, the MAPS staff hav e been generally successful in addressing client problems.