Table 1.

Key Points and Recommendations for Physicians with Patients in AL/RC.

AL/RC settings

State regulatory approaches are unique; states may have more than one AL/RC type Learn about AL/RC in your state, and bordering states, if relevant Reliance on paraprofessional staff, nurse availability varies Physicians are care convoy members

Care planning and communication

Evaluation/assessment informs the care plan Develop communication plans with AL/RC staff Identify residents’ preferences and key staff contacts

Care transitions

Move-in and move-out may require physician input Use communication plans to track care transitions/changes in condition Consider telemedicine options to facilitate in-place assessment and care

People living with dementia

Recognize dementia versus delirium Identify underlying causes of behavioral expressions Prioritize nonpharmacologic strategies Know psychotropic medication risks

Medication management

Frequently review medications and treatment orders Consider: Potential drug-induced delirium Untreated pain Unrecognized sleep disorders Anticholinergic effects Use clear, specific language in medication and treatment parameters

End-of-life care

Third-party services including hospice may require physician orders Discuss advance care planning with patients and families