DementiaRoadmap

It is recommended that on receipt of a formal diagnosis the patient and carer (or spouse or family member if care not yet identified) are invited for a face to face appointment with a GP in the practice where the patient is registered, to discuss how they are dealing with the diagnosis and what it means to them.

This appointment provides the practitioner with the opportunity to:

• Review existing medications and consider discontinuing any which might impact on the dementia (eg anticholinergic drugs, sedatives)
• Check for depression
• Review the patient’s cardiovascular risk and any necessary prevention strategies (especially if Vascular Dementia)
• Identify and information, support or educational needs and signpost appropriately
• Encourage a problem-solving approach to any functional issues
• Encourage regular moderate exercise, smoking cessation and weight loss if obese
• Discuss DVLA rules
• Encourage consideration of forward planning including setting up Lasting Power of Attorney for both health and financial affairs
• Signpost to local support groups
• If the person has a diagnosis of mild Alzheimer’s dementia consider discussing the option of them purchasing and taking daily Souvenaid® dietary supplement drinks which have some early evidence of improving memory (not available on prescription).

One member of the Primary Care Team may wish to develop skills to undertake this review for all diagnosed patients in the Practice population. This is suggested because the average whole time GP is likely only to have 2 or 3 patients per year diagnosed with dementia and at this frequency may find it difficult to build up a simple routine for covering all the points above in the time available