Primary Care Dementia Assessment in South Auckland DR MARK FISHER SARAH HEWITT RN

The Memory Team Confusion Agitation Loss of Function Hallucinations Non-compliance Dishevelled

EXTENDING OUR DEMENTIA SERVICE Waitemata Primary Care Dementia Pilot Similar Pilot - Franklin Waiuku Health Centre Patients: 12,600 (2500 over 65) 80% European 8 FTE GPs 7 FTE Practice Nurses

WAIUKU – THE DIFFERENCES At Risk Individuals Funding Computerised Cognitive Impairment Pathway Alzheimers Auckland not involved in Assessment

THE PILOT Training 12 months 66 patients referred All GPs involved Practice Nurses did assessments beyond screening Alzheimers Auckland accepted referrals for follow-up The Memory Team provided support

RESULTS: AGES 45-89

RESULTS N=66 MOCA N=44 Dementia N=16 MCI N=10 Uncertain Normal N=8 Nil

RESULTS: ALZHEIMERS AUCKLAND 12 people referred – 3 declined Higher cognitive and EADLs scores than usual Low carer stress No change over 6 months 7 / 9 completed EPOA

PRACTICE EXPERIENCE Pilot has Promoted Focus and Awareness Relationship with Alzheimers Auckland and Secondary Care Familiarisation with Care Pathway

PRACTICE EXPERIENCE At Risk Individual (ARI) Link Funding = Time and Coordination Nurse Involvement Continuity of Care

PRACTICE EXPERIENCE Practical Response to patient and carers’ expressions of concern Increased Willingness to address Cognitive Issues - including Early Presentations

STAFF SURVEY % “Ability to Recognize Need for Assessment is GOOD” “Arranging Testing is EASY”

STAFF SURVEY % “Pathway is USEFUL/ EASY to use” “USE STANDARDISED ASESSMENTS”

Need to Ensure Sustainability PRACTICE EXPERIENCE More Assessments More Diagnoses Better Uptake of Support Services Better Outcomes Need to Ensure Sustainability

WAIUKU DEMENTIA PILOT: CONCLUSIONS EARLY DIAGNOSIS TIME CONSUMING DIAGNOSIS ISSUE FOR PNs DATA EXTRACTION TRICKY 3 DIFFERENT COMPUTER SYSTEMS CT SCANS NOT COMPLETED

WAIUKU DEMENTIA PILOT: CONCLUSIONS WOULD BE ENHANCED BY A GPwSI