Dementia - Timely Diagnosis and Management
Our PHN supports activities to improve the timely diagnosis, management and support of people our region living with dementia, their carers and family.
One of the biggest issues facing those living with dementia, health professionals and carers, and our ability to implement appropriate management and care strategies, is that only fifty percent of all dementia cases in Australia are diagnosed. Of those that receive a diagnosis, the average delay between family members and close friends observing dementia symptoms and achieving a diagnosis is over three years.
Through early intervention, we can reduce the impact of dementia on our clients, their carers and families, and improve their quality of life – however, early intervention begins with timely assessment and diagnosis.
What is dementia?
Dementia is a chronic, progressive and terminal condition, consisting of a cluster of symptoms. There are over fifty subtypes of dementia, and each is associated with specific neurodegenerative pathology occurring in the brain. The most common forms of dementia are Alzheimer’s dementia, vascular dementia, and mixed Alzheimer’s and vascular dementia, followed by Lewy body dementia, frontotemporal dementias, and dementia due to Parkinson’s disease. Other less common forms include alcohol-related dementia, HIV-associated dementia and dementia due to Huntington disease.
Early signs are subtle and may be hard to pick up on, even for those close to the person concerned. The person with dementia may also have trouble recognising any changes within themselves. Early features vary a great deal and depend on the underlying brain pathology. Importantly, while memory difficulties may be the first sign, impairment to language, behaviour, or personality, and/or disruption to everyday tasks may also be an early sign.
Timely Assessment and Diagnosis
Timely diagnosis begins to enable a person living with dementia and their family to:
- Adjust to the diagnosis of dementia;
- Prepare for the future;
- Access appropriate medical intervention;
- Manage other symptoms such as behaviour and mood changes; and
- Review and manage current medications.
Symptoms similar to dementia can be caused by several different diseases and conditions, some of which are treatable and reversible, including infections, thyroid imbalances, depression, medication side-effects or nutritional deficiencies. The quicker an assessment can be conducted, the sooner appropriate management and treatment can begin.
Dementia can be diagnosed when there is a gradual decline in cognition, behaviour and/or personality that:
- Interferes with everyday function (work, social and /or domestic function); and
- Represents a decline from previous levels of functioning and performing; and
- Cannot be explained by an acute or chronic medical condition, neurological condition, delirium, or a major psychiatric disorder.
The evidence collected in an assessment needs to be sufficient to determine a dementia subtype (differential dementia diagnosis) to ensure appropriate treatment and management.
What does the PHN do to support dementia services in our region?
New England Dementia Partnership (NEDP)
The New England Dementia Partnership is a collaboration between HealthWISE New England North West, Hunter New England Local Health District (HNELHD) and the Primary Health Network that dates back to 2003. The aim of the Partnership is to work together to improve the health outcomes and quality of life for people with dementia and their family and carers living in the New England region of NSW.
The NEDP undertakes a range of activities to support people working in dementia care services, including:
The Dementia Care Information booklet: The information booklet for clinicians and health workers contains information on dementia and available services specific to the New England region. The purpose of the document is to assist healthcare providers to recognise, assess, diagnose and manage dementia. The booklet was published in 2016 and an electronic version on the PHN website contains up-to-date links to further information, templates and training opportunities. The electronic booklet can be accessed here.
Standardised referral to dementia services: Comprehensive dementia assessments can be undertaken and supported by dementia clinicians working within HealthWISE and HNELHD. The Dementia Partnership has created a standardised GP referral form for these services, including an electronic format that allows patient details and relevant clinical information to be populated from clinical information systems.
Multidisciplinary Clinical Case Discussion Framework: The NEDP established multidisciplinary team meetings for clinicians working in dementia services in the region to provide each other with peer support. A Clinical Case Discussion Framework was developed to use during case discussions and when reporting back to referring GPs to ensure accuracy and consistency of information presented.
New England Dementia Forum: The NEDP hosts a biennial dementia forum in Tamworth, bringing together dementia experts, local clinicians, and carers to learn about developments in dementia care and dementia related health implications. You can watch a recording of the 2021 forum here. Keep an eye on the PHN education events page for details on the next forum, due to be held in 2023. The New England Dementia Partnership acknowledges the NSW Agency for Clinical Innovation (ACI) for seed funding from the Building Partnerships program, which aims to improve care of older people with complex health needs.
For further information contact Ellen Meinel, Integrated Health Officer, HNECC PHN.
Central Coast Dementia Alliance (CCDA)
The CCDA aims to ensure a collaborative and integrated approach to the planning, implementation and evaluation of projects that improve the health, care, and quality of life of people living with dementia, their carers and families, as well as providing support to those who provide care and services to them.
The Alliance created the Central Coast Dementia Services and Supports Guide as a resource for health and community workers on the Central Coast supporting people living with dementia, their carers and families. The Alliance are currently developing a consumer toolkit with information and resources for local families impacted by dementia. The consumer toolkit will be available on the PHN website soon.
For more information, or if you have suggestions, updates or services to be added, please email the service information to Central-Coast-Dementia-Alliance@hneccphn.com.au
To stay up-to-date with the projects that CCDA is undertaking like the CCDA Facebook page.
Memory Assessment Program (MAP)
Our PHN commissions HealthWISE to deliver the Memory Assessment Program, supporting clients and their carers in the Tablelands region gain timely access to local dementia and carer support services.
The Memory Assessment program aims to improve the wellbeing and quality of life of people living with dementia and their carers by providing an early intervention cognitive screening and assessment service and coordinated pathway to specialist services for dementia management.
The program also offers support and education for carers designed to empower people caring for someone with dementia and support clients and carers to optimise their ability to live safely, independently, and confidently in the community.
The program is targeted to people with mild to moderate cognitive impairment seeking assessment for dementia and offers support and coordination of care from assessment and diagnosis of dementia through the progression of the disease.
Visit HealthWISE for more information on the Memory Assessment Program and other dementia resources.
For further information contact Emma Bohringer, HNECC PHN Commissioning Coordinator, Primary Care Services