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
Definitely no dementia - reassure and address anxiety or depressive symptoms or other unstable chronic illness.
Dementia is less likely but concern about cognitive change is present - acknowledge the symptoms being presented; provide simple hints for cognitive prompts (such as diary, whiteboard on the fridge or a pen tied to the phone and a pad close by) 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
KPMG Dementia services pathways - an essential guide to effective service planning 2011 pg. 20