Alzheimer's & Dementia APCM Enrollment Checklist

Confirm the legal healthcare proxy or primary family contact for all APCM communications and decision-making.

Document current MMSE, MoCA, or SLUMS scores to establish a clinical baseline for chronic care tracking.

Determine if the patient can participate in calls or if AI outreach should route directly to the caregiver.

Obtain and scan written or verbal consent for APCM services, specifically noting caregiver involvement in the process.

Identify primary language for both patient and caregiver to ensure AI voice agents utilize the correct dialect for clarity.

Record best times for AI-driven check-ins to avoid sundowning periods or caregiver work hours.

List all cholinesterase inhibitors, memantine, and psychotropic medications currently prescribed for dementia management.

Document existing gastrointestinal or sleep issues to monitor for medication-related changes via AI reporting.

Perform an initial safety assessment to trigger automated environmental safety reminders and mobility check-ins.

Catalog frequency of wandering, agitation, or sleep disturbances for longitudinal tracking in the APCM plan.

Identify secondary chronic conditions like hypertension or diabetes that complicate dementia care and medication adherence.

Score the patient’s ability to perform daily living tasks to justify the clinical need for intensive APCM services.

Confirm presence of living wills and DNR orders in the electronic health record and discuss goals of care.

Document specific triggers and safety measures, including GPS or alarm systems currently in use at home.

Update the multi-tier contact list for AI escalation during urgent behavioral or medical events.

Assess current caregiver burnout levels to schedule proactive respite care coordination calls via the AI system.

Set up automated reminders for caregivers to monitor fluid intake and weight changes to prevent dehydration.

Schedule a virtual or in-person review of the home environment for dementia-specific hazards like rugs or poor lighting.