Enhancing Dementia Care: A Primary Care–Based Memory Clinic

Abstract

Memory clinics have been promoted as opportunities for improving dementia diagnosis and care. This article describes the implementation of an interdisciplinary memory clinic within primary care in Ontario, Canada, that aims to provide timely access to comprehensive assessment and care and to improve referring physicians' knowledge of the management of dementia through collaborative care and practice-based mentorship. Between July 2006 and September 2009, 246 initial and follow-up assessments were conducted with 151 patients, a high proportion of whom received a new diagnosis of mild cognitive impairment (44.4%) or dementia (19.2%). A trial of cholinesterase inhibitors was recommended for almost all patients newly diagnosed with dementia. Management interventions and recommendations included social worker outreach, long-term care planning, home safety or driving assessments, referral to community resources, and periodic follow-up and monitoring. A small proportion of patients (7.8%) were referred to a specialist. Surveyed patients and caregivers were very satisfied with their visit to the clinic. A chart audit conducted by two independent geriatricians indicated agreement with diagnosis and intervention, particularly related to use of specialists. The results indicate that memory clinics within primary care settings can support capacity building to ensure quality assessment and management of dementia at a primary care level.

From forgetfulness to dementia: clinical and commissioning implications of diagnostic experiences

“…Alternatively, some of the problems of communication might be mitigated by situating memory assessment services in primary care settings that are familiar to individuals and their carers. [42][43][44] Policymakers and commissioners need to understand the diagnostic 'journey', which could inform any refreshing or evaluation of the National Dementia Strategy. Policymakers should act cautiously in giving the impression that rapid diagnosis is always possible or desirable.…”

Primary care-led dementia diagnosis services in South Gloucestershire: Themes from people and families living with dementia and health care professionals

“…However, the increased demand for early diagnosis places pressure on secondary services, including memory clinics, at a time when health services finances are already stressed. Consequently, increased attention is being paid to the possibility of enhancing the role of primary care teams in the assessment, diagnosis and treatment of people affected by dementia not just in the UK, but also in Canada (Lee et al 2010), USA (Boustani et al 2005), Norway (Engedal , Gausdal, Gjøra & Haugen 2013), Ireland (Cahill, Clark & O'Connell 2008) and Crete (Lionis et al 2001).…”

Étude exploratoire : perceptions, croyances, connaissances et attitudes d’un groupe d’aînés francophones du Nouveau-Brunswick concernant la démence et son diagnostic

“…D'ailleurs, les évaluations cognitives précoces auprès d'individus présentant des symptômes de démence, en plus de permettre l'identification et le traitement des pseudodémences au moment opportun, permettent le diagnostic précoce de la démence, lequel est entre autres nécessaire à la mise en place d'interventions visant à ralentir la détérioration cognitive et à améliorer la qualité de vie de l'individu atteint (Lee, et collab., 2010;Milne, 2010;Weimer et Sager, 2009;Camicioli, 2006). De plus, selon les résultats de l'étude de Weimer et Sager (2009), la prise en charge précoce de la démence permettrait de réduire de façon importante les coûts qui y sont associés.…”