DementiaRoadmap

Helping primary care to support people with dementia

Diagnosing well

Diagnosing dementia is often difficult, particularly in the early stages. The GP is usually the first person who is  consulted either by the person themselves or their family. The GP may then refer the person being diagnosed to a consultant for specialist assessment.

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Resources

  • Pre-memory assessment support project briefingSince the COVID-19 pandemic there has been an increase in the time people need to wait for their memory assessment appointment. This briefing published by the Dementia Change Action Network (DCAN) explores people’s experiences of waiting for a memory assessment.
  • Dementia wellbeing in the COVID-19 pandemicThis resource is primarily for clinicians working with people with dementia, but can also be used by carers and people with dementia. This document takes the Dementia Well Pathway and sets out the adjustments and amendments needed to respond to the COVID-19 pandemic. It highlights key priorities and actions for each step in the pathway.
  • The Many Faces of DementiaThis online course enables you to gain a unique insight into dementia through the stories, symptoms and science behind four less common diagnoses of dementia, the people involved and the implications of these for our wider understanding.
  • A Whole Systems Approach to understanding psychological symptoms in delirium and dementiaThis Yorkshire and the Humber Dementia and Older Peooples Mental Health Clinkcal Network event chaired by Dr Rod Kersh provided attendees with an opportunity to hear from local and national innovators and carers to better understand psychological symptoms in delirium and dementia.
  • Dementia: assessment, management and support for people living with dementia and their carersThis NICE guideline covers diagnosing and managing dementia (including Alzheimer’s disease). It aims to improve care by making recommendations on training staff and helping carers to support people living with dementia.
  • Do I see what you see?In this film, produced by Created Out Of Mind, people share stories and experiences of living with Posterior Cortical Atrophy (PCA), a rare form of dementia that commonly affects vision.
  • Implementation guide and resource pack for dementia careThis guide aims to set out the policy drivers and strategic context for transforming dementia care, and why it is of importance to commissioners, providers and sustainability and transformation partnerships (STPs) in supporting delivery of a number of objectives in the Department of Health’s Prime Minister’s challenge on dementia 2020, published February 2015, which complements the aims of the Five Year Forward View, published in October 2014.
  • Dementia Atlas: Putting a focus on dementiaThe Dementia Atlas is an interactive map that plots data about dementia care and support, allowing people to compare the quality of dementia care across the country.
  • DiADeM (Diagnosis of Advanced Dementia Mandate in Care Homes)This protocol developed by the Yorkshire and Humber Dementia Strategic Clinical Network aims to support GPs to diagnose dementia for people living with advanced dementia in a care home setting.
  • DeAR-GP (Dementia Assessment Referral to GP)DeAR–GP, developed by the South London Health Innovation Network, is a simple paper based case-finding tool which has been designed for use by care workers to identify people who are showing signs of dementia.
  • Prime Minister’s Challenge on Dementia 2020 Implementation PlanThis implementation plan outlines how the 50 commitments set out in the Prime Minister’s challenge on dementia 2020 will be met, ensuring that England becomes the world-leader in dementia care, research and awareness by 2020.
  • The dementia profileThe dementia profile developed by the Dementia Intelligence Network collects new and existing data on dementia at both Clinical Commissioning Group and local authority level. This will assist the local planning of services and support areas to make sustainable improvements from an easily accessible online platform.
  • Prevalence of dementia in population groups by protected characteristics: a systematic review of the literatureThis literature review published by Public Health England examines evidence on how the prevalence of dementia varies with different characteristics, such as ethnicity, gender and religion.
  • Models of dementia assessment and diagnosis: Indicative cost reviewThis report published by NHS England is designed to provide commissioners and service providers with detailed information about real alternative models of dementia assessment and diagnosis, with a cost breakdown.
  • Younger people with dementiaThis factsheet published by the Alzheimer's Society explores at the types of dementia that younger people under 65 years of age may have, some of the difficulties that they might experience and where support can be found.
  • Dementia and People with Intellectual Disabilities: Guidance on their Assessment, Diagnosis, Interventions and SupportThis guidance published by the British Psychological Society aims to promote effective and timely assessment, diagnosis, interventions and support to people with intellectual disabilities who develop dementia.
  • The Sound Doctor: Getting the best out of life with dementiaA series of films providing information to families living with dementia through the entertaining medium of TV/Film.
  • Prime Minister’s challenge on dementia 2020The Prime Minister recently launched the government’s five year vision for the future of dementia care, support and research, which follows on from the existing Prime Minister’s Challenge on Dementia, launched in March 2012.
  • Dementia Revealed: What primary care needs to knowThis toolkit written by Dr Elizabeth Barrett is intended as an educational resource for use by GPs and practice nurses to expand their knowledge and confidence.
  • Dementia assessment and referral 2014-15This data collection reports on the number and proportion of patients aged 75 and over admitted as an emergency for more than 72 hours who have been identified as potentially having dementia, who are appropriately assessed and, where appropriate, referred on to specialist services in England.
  • Five Year Forward ViewThe Five Year Forward View published by NHS England sets out why the NHS needs to change and various models of care which could be provided in the future to deliver transformed care for patients.
  • State of Care 2013/14This report published by the Care Quality Commission (CQC) reveals wide variation in the quality and safety of care for conditions such as dementia in England.
  • Building on the National Dementia Strategy: Change, progress and prioritiesThis report published by the All Party Parliamentary Party Group on Dementia (APPG) calls for a new long term strategy for dementia to be a worthy successor to the National Dementia Strategy for Dementia in England and the Prime Minister's challenge on dementia.
  • ACEmobileACEmobile is a mobile-friendly version of the Addenbrooke’s Cognitive Examination (ACE-III), a popular and commonly-used screening tools for dementia.
  • Montreal cognitive assessmentThe Montreal Cognitive Assessment (MoCA) is a rapid screening instrument for mild cognitive dysfunction suitable for use in primary care settings.
  • Addenbrookes cognitive examination-IIIThe Addenbrooke's Cognitive Examination-III (ACE) is one of the most popular and commonly used cognitive tests used in dementia clinics and in the assessment of other neurological disorders.
  • Mini-CogThe Mini-Cog is a brief cognitive function test to screen for cognitive impairment in older adults in the primary care setting.
  • General practitioner assessment of cognitionThe General practitioner assessment of cognition (GPCOG) is a reliable, valid and efficient tool to use to screen for dementia in primary care settings for people with carers.
  • Six Item Cognitive Impairment TestThe Six Item Cognitive Impairment Test (6CIT) is a brief cognitive function test which takes less than five minutes and is widely used in primary care settings.
  • Abbreviated mental test scoreThe Abbreviated mental test score (AMTS) was developed in 1972 for assessing cognition. The test takes around five minutes and is widely used, particularly in UK general hospital settings.
  • Referral for a diagnosisThis leaflet produced by the Lewy Body Society highlights the importance of practitioners identifying the main symptoms of Lewy body dementia early to enable referral to a specialist at a memory clinic for correct diagnosis to be made.
  • 10 key steps to improving timely diagnosis: A resource pack for Commissioners and General PracticesThis resource pack sets out key steps for Commissioners, and key steps for General Practices to improve the diagnosis of dementia, and the diagnosis pathway.
  • Putting dementia on the mapPutting dementia on the map published by the Department of Health draws on data and information about dementia health and care, dementia friendly communities and research.
  • Dementia: A state of the nation report on dementia care and support in EnglandThis report, published by the Department of Health, sets out what is known about dementia care, support and research. It highlights where improvements are being made and where improvements are needed.
  • Enhanced service for people with dementia in primary careThis short paper by Alistair Burns and Laurence Buckman summarises a multi-disciplinary group discussion on how the Enhanced Service might be optimally used to increase the numbers of people receiving a diagnosis and accessing post diagnostic support.
  • Guidance on the use of neuro-imaging in the assessment of dementia in Primary CareThis guidance for Clinical Commissioning Groups and Health and Wellbeing Boards covers the role of neuro-imaging in the assessment and diagnosis of dementia in primary care.
  • Frontotemporal dementiaThis article published in the British Medical Journal highlights some of the issues pertinent to Frontotemporal dementia, a clinically and pathologically heterogeneous group of non-Alzheimer dementias characterised collectively by relatively selective, progressive atrophy involving the frontal or temporal lobes, or both.
  • Dementia coding clean-up exerciseThis exercise devised by Dr Paul Russell aims to support GPs to identify problems in coding, which are contributing to low rates of dementia diagnosis on practice registers.
  • Dementia Prevalence CalculatorThe Dementia Prevalence Calculator presents an opportunity for all health communities to gain a better understanding of their local estimated prevalence of dementia in the community, and among people living in local care homes.
  • CMG48: Support for commissioning of dementia careThis guidance produced by the National Institute for Health and Clinical Excellence (NICE) summarises the key commissioning issues and the resource impact that will arise from implementing improvements in the quality of care for people with dementia, in line with the statements and measures that comprise the NICE quality standards for dementia.
  • QS30: Supporting people to live well with dementiaThis quality standard, published by the National Institute for Health and Care Excellence (NICE), covers the care and support of people with dementia.
  • Helping you to assess cognition: A practical toolkit for cliniciansThis toolkit published by the Alzheimer's Society provides guidance to clinicians about what cognitive function tests are available and how they may be used in clinical practice.
  • Dementia diagnosis resource packThis resource pack produced by Dementia Partnerships sets out key steps for Commissioners and General Practices to improve the diagnosis of dementia, and diagnosis pathways.
  • Dementia READ codesThis knowledge summary produced by Dementia Partnerships defines a standard set of READ codes for the diagnosis of dementia to be used by general practices and memory assessment services.
  • Unlocking Diagnosis: The key to improving the lives of people with dementiaThis report published by the All-Party Parliamentary Group on Dementia (APPG) explores the barriers to dementia diagnosis in the UK. It makes recommendations to improve diagnosis rates and provide better post diagnosis support for people with dementia.
  • Dementia commissioning for quality and innovationDementia commissioning for quality and innovation (CQUIN) aims to help identify patients with dementia and other causes of cognitive impairment, alongside their other medical conditions and to prompt appropriate referral and follow up after they leave hospital.
  • Care of people with dementia in primary careThis factsheet published by the Royal College of General Practitioners provides GPs with guidance on the care of people with dementia in primary care.
  • Guidance and standards for diagnosing dementiaThis guidance sets out the process and associated standards for making a diagnosis of dementia in primary health care services, and by specialist memory assessment services.
  • NICE Clinical guideline CG42 Dementia: supporting people with dementia and their carers in health and social careThis guideline, published by the National Institute for Health and Clinical Excellence (NICE), makes specific recommendations on Alzheimer's disease, dementia with Lewy bodies (DLB), fronto temporal dementia, vascular dementia and mixed dementias, as well as recommendations that apply to all types of dementia.
  • Improving services and support for people with dementiaThis report published by the National Audit Office presents findings from a study into the health and social care services available for people with dementia and their unpaid carers in England and whether they are providing effective and good quality support; and the scope for better use of resources against a background of rising demand.
  • Services for younger people with Alzheimer’s disease and other dementiasThis briefing paper jointly published by the Royal College of Psychiatrists and the Alzheimer's Society provides guidance on the services for younger people with Alzheimer’s disease and other dementias.
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