Consultation 3 - information review
During this consultation review the baseline information collected in the sMMSE or other cognitive screens and investigations. Discuss the results with the patient. Provide further clarification of presenting symptoms of cognitive change.
The Practice nurse can assist by asking the carer to complete the Informant package in the waiting room.
Decision Point Two
No dementia - reassure and address anxiety or depressive symptoms or other unstable chronic illness. Subjective Memory Complaint can be a helpful descriptive label. Review re persisting cognitive symptoms in 12 months.
Mild Cognitive Impairment - Cognitive change is present but it does not impact of daily functioning for more complex tasks - acknowledge the symptoms being presented; (go to 'Mild Cognitive Impairment (MCI)' in pathway) and plan a follow-up office cognitive test in six to twelve months.
Dementia / significant cognitive change possible
Option 1: GP led investigation - proceed to Carer / family Consultation 4 and Detailed Assessment Consultation 5 tabs for further information.
Particularly in rural settings, general practice / practice nurse-led investigations may support better coordinated and timely diagnosis when there is limited access to medical specialists. [1]
Option 2: Refer to CDAMS / specialist for further assessment - go to referral for diagnosis and management tab for further information.
Carer / informant assessment tools
1. KPMG Dementia services pathways - an essential guide to effective service planning 2011 pg. 20