Introduce questions about memory functioning in scheduled visits and routine health checks and investigations for people over 65 years. These might include,
annual checks for over-65s with long term conditions
annual flu clinic health questionnaires
adults with Downs Syndrome, over 40 years
Be alert to those cases involving
falls
patients failing to attend appointments
patients failing to collect dispensed medications
cases where a previous initial assessment for dementia has been undertaken
references to confusion, depression, problems thinking, reasoning, struggling to follow conversations, forgetfulness, and other changes in mood and cognition.
Remember that carers/families may bring their concerns to you. What should be the Practice’s response?
With your primary health care team, consider older patients who may be vulnerable, who may be presenting with a change in mood or cognition, or whose self care is deteriorating. Could memory problems be a feature? Would it be appropriate and timely to offer a memory check?
Check for a low threshold for assessing patients who are occupying community hospital beds for which the GP surgery provides clinical cover.
Consider patients who are in care homes. Where dementia is established,
Has a diagnosis been recorded and captured on the Practice dementia register?
Are these patients benefitting from regular health checks, and reviews of medication?
Are staff in the care home able to manage behaviours that challenge, offering alternatives to prescribing antipsychotics?
Are there trends in emergency admissions to hospital?
