🏅Your Path to Certification
Earn your way up three evidence-based tiers. Each builds on the last. Finish all three and receive your Certified Prepared Patient · Alzheimer's badge and printable certificate, recognized across the FFH Network.
Aware · Identity: Self-Advocate
You know your body and your disease. Layer 1 — Condition Literacy.
- Complete Modules 1–4 (Condition Literacy)
- Pass the "What Alzheimer's Is" quiz (≥80%)
- Identify your stage (MCI, early AD, moderate, severe, or mixed)
- Build your FINGER bundle weekly tracker + 10-warning-signs Notice and Name notebook
Active · Identity: Care Team Member
You partner with your team and navigate the system. Layer 2 — Care & System Literacy.
- Complete Modules 5–7 (Self-Monitor · When-to-Call · Cognitive-Outcome Companion)
- Demonstrate teach-back on your medication plan and the cluster-to-cognitive-outcome story
- Complete one "great visit" prep + debrief
- Build your When-to-Call plan + Care Team card
- Successfully resolve one prior auth, referral, or GUIDE-Model navigator engagement
Certified Prepared Patient · Identity: Ambassador
You teach, mentor, fight stigma, and shape research & policy. Layer 3 — Advocacy & Ambassadorship.
- Complete Modules 8–10 (Family/Caregiver/Continuum · Notice-and-Name Ambassador · Mastery)
- Mentor 1 newly-diagnosed family OR present at a support group / school / faith community
- Sign the Prepared Patient Pledge
- Complete advance care planning (POA, proxy, advance directive, POLST/MOLST, will)
- Submit one advocacy action (story, feedback letter, trial review, policy comment)
📋Master Pre / Post Assessment
Where You Stand — Confidence Before & After
Seven dimensions of being a Prepared Patient. Answer once at the start of your journey and again at the end. Your goal is to see real growth across understanding, self-management, communication, and optimal utilization — knowing when to call your team, when to use Day Hospital, and when to go to the ER. Your answers stay on this device unless you choose to share with your clinician.
📈 Your Pre→Post Growth
📞Know Who to Call — Before the ER
Memory care runs on a long arc — most days are routine, some days bring real safety questions, and rare moments are true emergencies. Knowing the right number to call — your memory team, the Alzheimer's Association helpline, or 911 — saves time, dignity, and unnecessary ED visits. Save these numbers in your phone today. The numbers below are placeholders — your institution will fill in the right ones for you.
🌡️ Sudden change over hours-to-days — think delirium, infection, stroke
Sudden new confusion, agitation, drowsiness, hallucination, falls, or incontinence in a person with dementia is delirium until proven otherwise — most commonly UTI, dehydration, new meds, constipation, pain, or stroke. Call your [Memory Clinic On-Call: (555) 222-9000] 24/7 or go to urgent care / ED. If face droop, arm weakness, speech change, or sudden balance/vision change — that's BE-FAST positive — 911.
🧭 New or worsening behavioral symptoms (BPSD) — call before the ED
For agitation, anxiety, sleep disturbance, hallucinations, or new resistance to care, call your [Memory Care Navigator: (555) 123-4567]. Most BPSD episodes are triggered by pain, infection, dehydration, sleep loss, environmental change, or unmet need — and respond to non-drug strategies first. The team can plan; the ED is rarely the right setting.
💬 Routine questions, refills, scheduling, caregiver support
Use [MyChart portal] first — most messages answered within 1 business day. For meds about to run out, call [Memory Care pharmacy line: (555) 222-9050]. For caregiver support, peer mentor matching, and local resources, call the Alzheimer's Association 24/7 helpline 800-272-3900 — free, real humans, around the clock.
🚑 Call 911 right away for any of these
Sudden one-sided weakness · face droop · slurred speech · sudden severe headache · sudden vision change · sudden balance loss · trouble understanding speech (BE-FAST positive). Wandering with the person not located within 15 minutes — call 911 + activate MedicAlert / Alzheimer's Association safe-return. Serious injury, suspected aspiration, or seizure — 911. Note the last known well or last seen time.
📚Condition Literacy & the 10 Prepared Patient Competencies
A Prepared Patient builds three kinds of health literacy — and grows into three identities. Each competency works through the FFH three pillars: Learn It · Live It · Share It.
Advocate for Self
You speak up for your own care, plan, pain, and goals.
Care Team Member
You partner with your team — not above, not below.
Ambassador
You teach, mentor, and shape research, policy & access.
🧬 Condition Literacy Learn It · Tier 1 Aware
"I know my body and my disease." The foundation. Without this, nothing else holds.
What Alzheimer's Is
Amyloid plaques + tau tangles. The most common cause of dementia. Why pathology starts 15–20 years before symptoms. The continuum from preclinical → MCI → mild → moderate → severe.
Know My Numbers & Risk Factors
Vascular numbers (BP, A1c, LDL), sleep / OSA, hearing, depression, social connection, APOE-ε4 awareness with limits. The cluster connection. Goal numbers + how to read your own labs.
Lifestyle Force Field — FINGER Bundle
Food (Mediterranean / DASH-MIND), Intellect, Networks, Gait, Ears+eyes, Rest+risk. The most-studied multidomain bundle for cognitive protection. Stack 3+ levers and the dementia risk curve bends measurably.
Medications — Honest Framing
Cholinesterase inhibitors + memantine (modest symptomatic), lecanemab / donanemab (disease-modifying with real ARIA risk and careful selection), behavioral meds (cautious; antipsychotic black-box). Adherence is the lever you control.
🤝 Care & System Literacy Live It · Tier 2 Active
"I'm part of the team. I navigate the system." Where most preventable ER visits, readmissions, and frustration happen — and where this course pays off the most. Optimal utilization lives here.
Self-Monitor — 10 Warning Signs at Home
The 10 warning signs as the at-home recognition code. Notice and Name (date, change, example). Home strategies — calendar, lists, launchpad, environment. Normal aging vs concerning. When to schedule.
When to Call vs Go to ED — and Delirium
Sudden vs gradual is the master question. Sudden change = delirium until proven otherwise (UTI, dehydration, meds, stroke). Gradual = scheduled visit. BPSD non-drug strategies first. Safety triggers: wandering, driving, guns, stove, meds. BE-FAST still applies.
Cognitive-Outcome Companion · When the Cluster Comes Back
Same 5-way cluster (SCD + HTN + OSA + T2D + Stroke/TIA) — two outcomes. Acute = stroke. Chronic = vascular cognitive impairment / vascular dementia / amplified Alzheimer's risk. Mixed dementia. Lancet 14 modifiable factors.
📣 Advocacy & Ambassadorship Share It · Tier 3 Certified
"I speak up. I lift others. I shape the future." This is what turns a Prepared Patient into a force multiplier for the whole community.
Family, Caregiver & the Care Continuum
The care partner is the second patient — caregiver burden + respite are real medicine. Care continuum: clinic → adult day → in-home → AL/MC → SNF → hospice. GUIDE Model navigation. Advance care planning early.
Teach Notice and Name · Mentor · Ambassador
The person most likely to spot Alzheimer's early is a family member, not a doctor. Teach the 10 warning signs. The high-school grandparent observation case. Mentor newly-diagnosed families. Speak at faith / employer / school venues.
Mastery & Graduation
Advance care planning complete. Caregiver wellness plan in place. Peer mentoring active. Story contributed to the FFH staff training library. Earn Certified Prepared Patient · Alzheimer's. Become the person you needed at diagnosis.
👥My Care Team
Your team is bigger than just the doctor — and the care partner is part of it. Click any card to edit, or click the + tile to add a new team member. Saved on this device. The Force Field Emergency Card below auto-syncs from this list. Edit the CARE_TEAM_DEFAULTS array in the script block to set the starter roster for Alzheimer's.
📖Glossary — words you'll hear
Plain-English definitions for terms doctors and labs use. Tap to expand.
Alzheimer's disease
Mild Cognitive Impairment (MCI)
Mixed dementia
10 Warning Signs (Alzheimer's Association)
Notice and Name
FINGER bundle
Cholinesterase inhibitors / memantine
Lecanemab / donanemab (anti-amyloid monoclonals)
ARIA (Amyloid-Related Imaging Abnormalities)
Delirium superimposed on dementia
BPSD (Behavioral and Psychological Symptoms of Dementia)
GUIDE Model (CMS)
APOE-ε4
Lancet Commission on Dementia (2024 update)
🧪Lab Test Tutor — what your numbers mean
Lab Test Tutor — what your numbers mean
Don't just see a number — know what it means and what to ask. Your "normal" may be different from a friend's. Ask your team to write your personal baseline in the column on the right.
| Test | What it measures | Typical adult range | What to ask if it's off | My baseline |
|---|---|---|---|---|
| Mini-Cog / MoCA | Plain-language office cognitive screens. Family/Ambassador can flag — clinician diagnoses. | Mini-Cog <3 / MoCA <26 = further evaluation | Have I had a baseline Annual Wellness cognitive screen? | [fill in] |
| BP (Blood Pressure) | The brain is a vascular organ. SPRINT-MIND showed intensive BP control reduced incident MCI. | Goal: <130/80 (often lower) | Am I at goal? Any med change needed? | [fill in] |
| A1c | 3-month average blood sugar. T2D ~doubles dementia risk. | Goal <7% if diabetic | Should we add an SGLT2 or GLP-1 for cardio benefit? | [fill in] |
| LDL cholesterol | Vascular driver. Lower = less small-vessel disease. | Often <100 (lower if ASCVD) | Am I on the right statin and is my LDL at goal? | [fill in] |
| Hearing test (audiogram) | Untreated hearing loss is one of the largest single Lancet modifiable factors. Hearing aids reduce dementia risk in those with hearing loss. | Pure-tone average ≤25 dB normal | Should I be tested? Should I trial hearing aids? | [fill in] |
| Sleep study (PSG / home test) | Untreated OSA is a meaningful dementia risk factor. | AHI ≥5 = OSA; treat with CPAP | Have I been screened (STOP-BANG)? Sleep study? | [fill in] |
| PHQ-9 (depression screen) | Depression is both a treatable risk factor and a mimic for dementia. | ≥10 = moderate; warrants attention | Could low mood be making my memory feel worse? | [fill in] |
| TSH / B12 / CMP | Rules out reversible mimics (thyroid, B12 deficiency, electrolyte issues). | Lab-specific normals | Have these been checked recently to rule out reversible causes? | [fill in] |
| Brain MRI | Looks for vascular damage, atrophy patterns, rules out other causes (tumor, NPH, subdural). | Read in context | Do I have a recent brain MRI? What did it show? | [fill in] |
| Plasma p-tau 217 / amyloid biomarker | New blood-based biomarkers are bringing diagnosis earlier and less invasively. Required if anti-amyloid monoclonal is being considered. | Test-specific positive thresholds | Am I a candidate for biomarker testing? | [fill in] |
➕Add-On Modules & Earnable Badges
Stackable modules that match your situation. Complete one to earn an extra badge on your certificate. Your institution can add their own.
💉 Considering an Anti-Amyloid Monoclonal?
Candidacy, ARIA risk, MRI schedule, infusion logistics, anticoagulation review, shared-decision conversation.
🚗 Driving Evaluation
When to schedule, what the formal evaluation looks like, how to step down gracefully, alternatives.
📍 Wandering Safety Bundle
GPS wearable, MedicAlert, Alzheimer's Association safe-return registry, simplified locks, neighborhood awareness.
👂 Hearing Aids — Daily Wear Routine
The Lancet's largest single modifiable factor. Fitting, cleaning, charging, daily-wear habit, problem-solving.
🌬 CPAP Onboarding (if OSA)
Mask fit, ramp settings, adherence troubleshooting, why CPAP is brain-protective medicine.
🧪 In a Clinical Trial?
Protocol literacy, side-effect tracking, when to call the study coordinator vs your usual team. Trial-of-One option.
📋 Advance Care Planning Workshop
POA, healthcare proxy, advance directive, POLST/MOLST, will, financial plan — done early while capacity is clear.
👨👩👧 Care Partner Wellness
Zarit Burden self-check, respite calendar, caregiver therapy, the high-school grandparent observation case.
+ Add Your Institution's Module
Drop in your own — local memory clinic onboarding, GUIDE-Model navigator intro, anything.
🛡️Force Field Emergency Card
🛡️ Force Field Emergency Card FRIDGE · WALLET · EMT-READY
A one-page emergency record for any EMT, ER, new doctor, or transition visit. Print one for the fridge, one for your wallet. Updates anytime. This is the document you hand to a stranger when you can't speak for yourself.
🤝 My Care Team — call list for any clinician picking up my care
📘My Health Passport
📘 My Health Passport PATIENT-OWNED JOURNAL
This is your record — not your hospital's. Log every visit, capture every question for next time, and watch your own trends. Many of you get care at more than one hospital, on more than one record system. This Passport travels with you. Future versions will let you import data directly from your patient portals (the "Blue Button" vision).
🩺Working With a Prepared Patient
Your patient is going through a structured, evidence-based course. Here's how to get the most out of every visit, reduce ED use, support the care partner, and partner well. Built on the AHRQ SHARE Approach, the IOM teach-back method, the AAN Cognitive Impairment Practice Guidelines, the 2024 AHA/ASA / AAN guidance on anti-amyloid monoclonals (lecanemab/donanemab), and the Lancet Commission on Dementia Prevention 2024 update.
The SHARE Approach — your 5-step playbook
Use these steps in any order. Cycle back. Use teach-back at every transition. Source: AHRQ Pub. No. 25-0005 (Oct 2024).
💬Teach-Back & Risk Communication
The two highest-yield, lowest-cost SDM techniques. Use both at every visit.
🔁 Teach-Back (1–2 min)
- "Just so I know I explained it well — what would you tell your daughter about why we're starting donepezil (or considering lecanemab)?"
- Open-ended ("what" / "how"), not yes/no.
- If they get it wrong: "I must not have explained it well — let me try a different way." Then teach-back again.
- Use it for: 10 warning signs, the cluster-to-cognitive-outcome story, medication plan + ARIA call triggers, when to call vs ED, advance care planning.
- Document teach-back in your note — it's a quality measure and a billable element of care.
🔢 Communicating Numbers
- Use absolute risk, not relative. "13 out of 100" beats "13%" beats "1 in 8" beats "low risk."
- Keep denominators & timeframes constant when comparing options.
- Show, don't tell: icon arrays, Wong-Baker FACES, written summary.
- For lab / score numbers: give the action threshold, not just the value. "Your MoCA is 23 — under 26 we usually go to a memory clinic for a fuller workup."
⚠️Alzheimer's-Specific Clinical Guardrails
Diagnostic Workup
- Annual Wellness Visit cognitive assessment for all Medicare patients 65+; Mini-Cog or MoCA at baseline.
- Rule out reversible mimics: TSH, B12, CMP, depression screen, OSA screen (STOP-BANG), medication review.
- Brain MRI for new dementia workup (rules out NPH, subdural, tumor; quantifies vascular burden).
- Refer to neuropsychology for diagnostic clarity and functional baseline when MCI vs early dementia is unclear.
- Plasma p-tau 217 / amyloid biomarker when monoclonal candidacy is being considered or diagnosis unclear.
Treatment
- Cholinesterase inhibitors (donepezil first-line for most) in mild-to-moderate AD; titrate slowly to manage GI side effects; recheck pulse for bradycardia.
- Memantine in moderate-to-severe AD; can combine with cholinesterase inhibitor.
- Lecanemab / donanemab: confirm early-symptomatic AD, amyloid-positive biomarker, no contraindicating MRI findings, anticoagulation review. Consent ARIA risk (higher in APOE-ε4 homozygotes). Serial MRI per protocol.
- Behavioral symptoms (BPSD): rule out delirium / pain / infection / unmet need first; non-drug strategies first; antipsychotics only after non-drug fails, lowest effective dose, plan to taper, document black-box informed consent.
- Vascular risk factors: BP <130/80, A1c <7%, LDL to ASCVD-appropriate goal, treat OSA, treat hearing loss with aids, screen / treat depression, address social isolation.
- GUIDE Model navigator referral early; advance care planning while capacity is clear.
🌍Cultural Competence & Trust
Alzheimer's disproportionately affects Black Americans (~2× risk) and Hispanic Americans (~1.5× risk) vs non-Hispanic white Americans, driven heavily by the same vascular comorbidity cluster (HTN, T2D, OSA, sickle cell disease). Bias in diagnosis, trial enrollment, and GUIDE-Model access is well documented. Repair starts in your office.
- Start with belief. When a family says "something's different about Mom," document and evaluate. Subtle early presentations are still often dismissed.
- Ask about their model. "What do you and your family think is happening? What changes have you noticed in the last 6 months?" Use that language.
- Use qualified medical interpreters — never family, never minor children except in true emergencies. Cognitive assessments must be done in the patient's primary language.
- Invite the care partner in. With patient consent — decisions about diagnosis disclosure, monoclonals, advance care planning, and behavioral plans are family decisions in many cultures.
- Name the bias. "I know dementia symptoms in Black and Hispanic patients are often dismissed or attributed to other causes. We track that here, and you can tell me if it ever happens."
🏥Customize for Your Institution
Clone this course and replace the highlighted blocks with your own information. Each editable field below is a placeholder — change it once and it propagates through the patient view.
📞 What Should Replace the When-to-Call Block
- 24/7 memory clinic / cognitive neurology on-call number
- Memory clinic outpatient hours & address
- Specialty pharmacy line
- Behavioral health / care-partner support line
- Alzheimer's Association local chapter contact
- Patient portal login URL with care-partner proxy
👤 Who Is Your Memory Care Navigator?
- Name, role, photo, calendly/booking link.
- What teach-back / device check-ins they own (FINGER bundle adherence, pill dispenser, GPS wearable, hearing-aid daily wear, CPAP, BP cuff).
- How patients and care partners reach them between visits.
- GUIDE-Model navigation status.
📚 Add Your Own Modules
- Your clinical trial protocols (lecanemab/donanemab onboarding, observational cohorts).
- GUIDE-Model navigator onboarding letter.
- Insurance & financial-aid pathways (especially monoclonal access).
- Local peer support partners (Alzheimer's Association local chapter, caregiver support groups).
🎨 Re-skin in 2 Lines of CSS
--inst-primary: your brand color- Replace the FFH × Alzheimer's Association × [Your Institution] cobrand pill in the hero
- Drop in your logo PNG (white version) — same 48px height as FFH logo
📚 Evidence Base — what this course is built on
- AHRQ SHARE Approach — 5-step shared decision making framework. AHRQ Pub. 25-0005, Oct 2024. ahrq.gov/sdm
- AHRQ Health Literacy Universal Precautions Toolkit (3rd ed.) — teach-back, plain language, accessible materials. AHRQ Pub. 23-0075, March 2024.
- Alzheimer's Association · 2025 Facts and Figures — epidemiology, disparities, caregiver burden, 10 warning signs, FINGER framework references.
- NIH National Institute on Aging — Alzheimer's Disease Education Program, biomarker guidance, public-facing materials.
- AAN Practice Guidelines — Cognitive Impairment evaluation; Lecanemab and Donanemab guidance (with ARIA monitoring protocols).
- Lancet Commission on Dementia Prevention, Intervention, and Care (2024 update; Livingston et al.) — 14 modifiable risk factors accounting for ~40% of dementia.
- USPSTF — Cognitive Impairment Screening Recommendations (Annual Wellness Visit cognitive assessment).
- SPRINT-MIND trial — intensive BP control reduced incident MCI (vascular numbers as cognitive protection).
- FINGER trial (Ngandu et al., Lancet 2015) and World-Wide FINGERS network — multidomain lifestyle intervention with 2-year cognitive protection signal.
- CMS GUIDE Model (2024) — payment model for dementia care navigation.
- AHRQ PEMAT — Patient Education Materials Assessment Tool. Used to grade understandability & actionability.
- Stanford Chronic Disease Self-Management Program (CDSMP) — peer-led, self-efficacy backbone of the Tier 3 advocacy work.
- FFH Prepared Patient · Stroke course — sister course; this build is the chronic-outcome companion to that acute-outcome arc.
Course content is educational and not a substitute for medical advice from your own clinicians. Institutions cloning this course are responsible for accuracy of all customized blocks.