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

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

3. 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

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

5. 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

6. RESULTS: AGES 45-89

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

8. 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

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

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

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

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

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

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

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

16. WAIUKU DEMENTIA PILOT: CONCLUSIONS
WOULD BE ENHANCED BY A GPwSI