Transcript memory assessment management plan

Referred by:
Family/friend/neighbour
A&E/Ambulance service
Homecare/Day Centre
Social Services
GP Assessment
Blood screen
B12
TSH
U&E
Calcium
B Glucose
Cholesterol
Folate
FBC
Referral
Yes
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?
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
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
Follow-Up in 12
months via
telephone to
ascertain if
reassessment
required
Yes
Diagnosis of Mild
Cognitive
Impairment?
Attend diagnostic clinic – Diagnosis of
Alzheimer’s disease?
No
Diagnosis
Family Support Worker input – link to
appropriate community support
No
Diagnosis of vascular dementia? –
signpost as appropriate
Diagnosis of depression? – signpost as
appropriate
No mental health problems? – support
in primary care
Yes
Drug treatment for Alzheimer’s
disease?
No
Signpost as
appropriate
Drug treatment for
Alzheimer’s disease?
Treatment/
Follow-up
No
Signpost as
appropriate
Yes
Follow-Up
4 weeks supply at introductory dose, seen within 3
weeks or sooner to ascertain any problems/adverse
reactions to medication
Liaise with the consultant.
Review for a prescription of the
titrated dose
No
Problem?
Problem?
Monitor again 2 to 3 weeks to
ascertain if any problems or
adverse reactions to medication
Yes
No
Problem?
Discharge to Primary Care for 12
month GP appointment – this should
be completed as per QOF
Yes
No
Problem?
Monitor again 6 weeks to
ascertain any problems or
adverse reactions to medication
Yes
No
Yes
Liaise with the consultant and
arrange clinic appointment as
appropriate