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Published byAndres Reeve Modified over 9 years ago
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GP Assessment Blood screen B12 TSH U & E Calcium B Glucose Cholesterol Folate FBC Referred by: Family/friend/neighbour A&E/Ambulance service Homecare/Day Centre Social Services Exclude/treat Aggravating factors Physical illness Vitamin deficiency Head injury Hypothyroidism Depression presenting as dementia Patient presenting with memory problems or other causes ruled out? Vascular problems – known patients with CVA and memory problems? Yes Refer to Memory Clinic. Assessment completed in primary care based clinics or if needed at patient’s home MMSE/DEMTEC/CAMCOG Family and personal history, physical health history, mental state presentation, carer concerns Referral
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Refer to Memory Clinic. Assessment completed in primary care based clinics or if needed at patient’s home MMSE/DEMTEC/CAMCOG Family and personal history, physical health history, mental state presentation, carer concerns Attend diagnostic clinic – Diagnosis of Alzheimer’s disease? Family Support Worker input – link to appropriate community support Yes No Diagnosis of Mild Cognitive Impairment? Follow-Up in 12 months via telephone to ascertain if reassessment required Diagnosis of vascular dementia? – signpost as appropriate Diagnosis of depression? – signpost as appropriate No mental health problems? – support in primary care Drug treatment for Alzheimer’s disease? Yes No Signpost as appropriate Diagnosis
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Drug treatment for Alzheimer’s disease? No Yes Problem?Yes Liaise with the consultant and arrange clinic appointment as appropriate No Liaise with the consultant. Review for a prescription of the titrated dose Monitor again 2 to 3 weeks to ascertain if any problems or adverse reactions to medication Problem?Yes Monitor again 6 weeks to ascertain any problems or adverse reactions to medication No Problem?Yes No Discharge to Primary Care for 12 month GP appointment – this should be completed as per QOF Problem?Yes No Follow-Up 4 weeks supply at introductory dose, seen within 3 weeks or sooner to ascertain any problems/adverse reactions to medication Signpost as appropriate Treatment/ Follow-up
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