Referral

When people are offered an assessment, or referred for a memory assessment:

• they should not have to wait long for an assessment, and have the option of having the assessment at home;
• they should be confident that any tests that they have are necessary;
• they should have a choice about whether they receive a formal diagnosis.

Useful resources

• Dementia Quality Standards (National Institute for Health and Clinical Excellence, 2010)
• Worried about your memory? (Alzheimer’s Society, 2011)
• What your diagnosis means for you (Alzheimer’s Society, 2010)
• Memory service – easy read (Department of Health, 2011)
• Keeping safe in your home (Alzheimer’s Society, 2010)
• Living alone (Alzheimer’s Society, 2010)
• Dementia service for people living at home or in a care home – easy read (Department of Health, 2011)

Specialist memory services

Will provide

• confirmation of diagnosis and sub types
• post-diagnosis counselling and advice
• prescribing advice; advice on medications management
• recommendations for continuing plan of care,
• signposting to community resources, facilities, and information

Some memory services may also undertake patient reviews at intervals agreed with the patient and GP.

Mild cognitive impairment

• Mild Cognitive Impairment (MCI) is a syndrome defined as cognitive decline greater than expected for an individual’s age and education level, which does not interfere notably with activities of daily living.
• MCI is not a diagnosis of dementia of any type, although it may lead to dementia in some cases (NICE Clinical Guideline 42, 1.3.3.1).

Mild cognitive impairment: treatment and care

• People diagnosed with MCI (including those without memory impairment, which may be absent in the earlier stages of non-Alzheimer’s dementia) should be offered follow-up to monitor cognitive decline and other signs of possible dementia in order to plan care at an early stage. (National Institute for Health and Clinical Excellence and Social Care Institute for Excellence, 2006)
• People with MCI should be offered assessment and management of cardiovascular risk factors. Primary care assessment of cardiovascular risk factor is appropriate.
• People with MCI should be offered annual review including cognitive assessment.

References

• National Institute for Health and Clinical Excellence and Social Care Institute for Excellence (2006). Dementia: The NICE/SCIE guideline on Supporting People with Dementia and their Carers in Health and Social Care. London, NICE. View this document