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Early-onset dementia and its social impact: the family doctor role

Maria GAMENHAS, Ricardo MARQUES, Sofia NEVES, Teresa ANTUNES and André NEGRÃO

A 52-year-old woman with early-onset dementia experiencing a significant impact on her work and social life. The underlying pathology presents with an inability to manage finances, schedule appointments, cook, time and space disorientation, and aphrasia. The only family support she has is her 86-year-old father, who does not understand his daughter's condition.Without family support, and without a way to communicate with the patient (she has no phone or email), getting her to attend appointments, have exames done, or take her medication was a Herculean task. The case was presented to the health center team, and several possibilities were proposed: sending her to the Neurologic emergency service, contacting the Social Worker, scheduling a home visit. It was agreed with the team that whenever the patient comes to the health center, the family doctor should be contacted to examine her (the patient never shows up on the day of her appointment because she forgets the scheduling).The family doctor opted to establish a network of social support: scheduled a home visit with the social worker, a certificate of incapacity for work was issued and directly delivered by the doctor to the employer, a medical board for verification of incapacity at home was requested, the patient was assisted in filling out the incapacity certificate, the Health Delegate was contacted to expedite the process of applying for an invalidity pension (to be done at home), and long-term support was proposed such as: home support, assisted adult status or institutionalization.More pre and post-graduated training in ​​social support would have facilitated the management of this patient and should be a point of reflection for the training of today's doctors, knowing that we will have increasingly more dependents (mostly elderly) in our society.The doctor is the patient's advocate, only seeking their well-being and health.The family doctor's role goes further, involving establishing a support network, guiding the patient, showing him alternatives, working together with the social worker, other specialties and the employer, with a single purpose – the patient's well-being.