Consultation 5 - detailed assessment
GP investigation undertaken during this consultation should include a detailed general history from the patient and carer (if available).
Review patient notes and perform a full physical examination.
An assessment of the patient's functional ability (IADL tool) should also be completed at this time.
An assessment of psychological function and mood (Geriatric Depression Scale) should be undertaken or repeated if necessary.
Decision Point Three
Dementia likely but complex, Atypical, under 65, severe behavioural disturbances, complex co-morbidities
Refer to the Cognitive Dementia and Memory Service (CDAMS) or another specialist
The following information should be included with each referral:
- Brief clinical history
- Investigation results
- Past history
- Medication list
- Copy of sMMSE and supporting assessment tools
Go to the Referral for diagnosis and management tab for further information.
Definite dementia non complex - provide advice to the patient and carer and establish the cause of the dementia with a view to considering pharmaco-therapy (in conjunction with a specialist).
- Begin to address legal, support, education and driving issues - refer to Medicolegal issues tab for further information.
- Arrange a GP Management plan and Team care arrangement - see here.
- The GP Management plan should address key issues including Enduring Powers of Attorney, Advance Care Plans, driving, work (if employed), medication, lifestyle and health.
- Consider referring the patient to the Aged Care Assessment Service (ACAS) via My Aged Care where patient's care needs are significant and complex.
- Consider referring the patient to the Dementia Behaviour Management Service (DBMAS) when carers are having difficulty dealing with behaviours and psychological symptoms of dementia.