“We need a one-stop-shop”: co-creating the model of care for a multidisciplinary memory clinic with community members, GPs, aged care workers, service providers, and policy-makers

Abstract

Background: Timely diagnosis of dementia has a wide range of benefits including reduced hospital emergency department presentations, admissions and inpatient length of stay, and improved quality of life for patients and their carers by facilitating access to treatments that reduce symptoms, and allow time to plan for the future. Memory clinics can provide such services, however there is no 'gold standard' model of care. This study involved the co-creation of a model of care for a new multidisciplinary memory clinic with local community members, General Practitioners (GPs), policy-makers, community aged care workers, and service providers. Methods: Data collection comprised semi-structured interviews (N = 98) with 20 GPs, and three 2-h community forums involving 53 seniors and community/local government representatives, and 25 community healthcare workers. Interviews and community forums were audio-recorded, transcribed verbatim, and coded by thematic analysis using Quirkos.Results: GPs' attitudes towards their role in assessing people with dementia varied. Many GPs reported that they found it useful for patients to have a diagnosis of dementia, but required support from secondary care to make the diagnosis and assist with subsequent management. Community forum participants felt they had a good knowledge of available dementia resources and services, but noted that these were highly fragmented and needed to be easier to navigate for the patient/carer via a 'one-stop-shop' and the provision of a dementia key worker. Expectations for the services and features of a new memory clinic included diagnostic services, rapid referrals, case management, education, legal services, culturally sensitive and appropriate services, allied health, research participation opportunities, and clear communication with GPs. Participants described several barriers to memory clinic utilisation including transportation access, funding, awareness, and costs.

Improving outcomes for people with mild cognitive impairment: An Australian mixed‐methods pilot study

“…The small sample size of this study does not allow generalisation to the population of interest. This finding is consistent with Steiner et al 20 who has recommended a review of the model of care in an Australian memory clinic to develop a ‘one‐stop‐shop’ assisting community members, GPs and service providers for early‐stage diagnosis. Identifying clear referral pathways for the diagnosis and management of MCI must be addressed to enable larger studies to be conducted in the future.…”

Dementia Risk Reduction in Practice: The Knowledge, Opinions and Perspectives of Australian Healthcare Providers

“…Travers and colleagues conducted a review of educational and behavioural interventions for risk reduction in primary care and suggested that these approaches are at most, moderately effective 12 . This is consistent with other work by Steiner and colleagues who also found that GPs were unsure of what dementia resources were available and how to access them 14 . This indicates that resource creation is necessary, but not sufficient to generate practice change.…”

What we need as we get older: needs assessment for the development of a community geriatrics service in an Australian context

“…Under the MBS, a rebate is payable once annually for each eligible patient [ 51 ]. The affordability of the CGS is paramount, as participants in similar studies have expressed that specialist geriatric services should be free of cost or have minimal out-of-pocket expenses to ensure service utilisation [ 52 ].…”