The disease course can run up to twenty years or more, so it is important that you select a physician you like and trust. This physician need not be the one who gave the diagnosis of Alzheimer's, nor does it have to be a specialist. However, he or she should meet the following requirements:

* Have a knowledge and understanding of Alzheimer's disease and delirium and of medications to treat secondary symptoms.

* Have the time and inclination to listen to you and the person with Alzheimer's and address your questions and concerns.

* Be easily accessible and have a qualified colleague who takes over when he or she is out of reach.

* Refer you to various other doctors who can address specific needs.

Ideally the one who coordinates the person's medical care would be your family physician---a general practitioner or internist who knows the person's medical history and personality before the Alzheimer's person developed the disease.

When seeking a new physician, compile a list of doctors whose work is praised by people you respect---friends, family members, community leaders, other health care workers, other physician specialists. You can also consult the Dictionary of Medical Specialists, which is available at your local library. Look for a neurologist or general practitioner experienced in caring for the elderly.

Often recommendations from other caregivers offer the most insight. Next set up a consultation with each perspective physician. Be prepared to pay a fee, usually equal to an office visit. When setting the consultation appointment, get as much information as you can about how the doctor runs the practice, including office hours, waiting for appointments, and payment schedules. In addition to getting helpful information, asking questions permits you to assess the cordiality and professionalism of the office staff.

Following are some tips for finding the best possible physician to coordinates the person's care and be available to respond to your questions and concerns. When you have narrowed your selection to one or two, consider bringing the person with Alzheimer's with you to be interviewed to see how he or she and the doctor interact with each other.

What To Look For In A Physician: A Checklist

A good physician provides you with information in a forthright way, treats you with respect and concern, and has an office that is efficiently and friendly. It's best to "doctor shop" as early in the disease as possible, but it's never too late to change if you feel your current physician is not meeting your needs. The following checklist provides you with questions to ask yourself during the selection process:

Does the Doctor:

* Communicate with me in a way I can understand without being condescending? Allows me to express fears about the person's symptoms or certain forms of treatment? Gives me real information about the person's condition instead of a simple pat on the back and reassurance? * Seem knowledgeable about Alzheimer's, including the latest treatment options for specific symptoms?

* Explain medical tests and procedures before performing them? Discuss potential side effects or complications?

* Take the time to answer my questions and those of the person with Alzheimer's without rushing us?

* Talk with the individual as a person before beginning examination? Treat us courteously and with respect?

* Behave in an authoritarian way? Or in an easygoing way?

* Seem comfortable with the idea of my getting a second opinion? Or threatened and defensive?

* Have a staff that is efficient and friendly?

* Have regular office hours during the day, evenings and weekends? Have a backup physician when he or she is not available?

* Regularly keep to the appointment schedule instead of keeping us waiting for long periods of time in the waiting room?

* Permit me to pay over time when visits aren't covered by insurance?

(c) copyright 1995