Search results

Despite evidence that early identification of dementia is of growing policy and practice significance in the UK, limited work has been done on evaluating screening measures for use in primary care. The aim of this paper is to offer a clinically informed synthesis of research and practice‐based evidence on the utility, efficacy and quality of dementia screening measures. The study has three elements: a review of research literature; a small‐scale survey of measures employed in three primary care trusts; and a systematic clinical evaluation of the most commonly used screening instruments. The authors integrated data from research and clinical sources. The General Practitioner Assessment of Cognition (GPCOG), Memory Impairment Screen (MIS) and Mini‐Cognitive Assessment Instrument (Mini‐Cog) were found to be: brief; easy to administer; clinically acceptable; effective; minimally affected by education, gender, and ethnicity; and to have psychometric properties similar to the Mini Mental State Examination (MMSE). Although the MMSE is widely used in the UK, this project identifies the GPCOG, MIS and Mini‐Cog as more appropriate for routine use in primary care. A coherent review of evidence coupled with an in‐depth evaluation of screening instruments has the potential to enhance ability and commitment to early intervention in primary care and, as part of a wider educational strategy, improve the quality and consistency of dementia screening.

This article aims to describe the aims, role and impact of a specialist intermediate care service for people with dementia in Kent, entitled the Home Treatment Service (HTS). The authors reflect on two workshops about the service, delivered as part of the “Dementia Care: A Positive Future” conference held in May 2010.

The 45 participants in the workshops included service providers, professionals and family carers. The aims and nature of the service were outlined by members of the clinical team as: adopting a multi‐professional approach, emphasising the value of a shared assessment process and having a commitment to flexible and intensive working within a person centred framework.

Focusing on the HTS's work with care homes, presenters offered case illustrations to highlight its collaborative approach to working with service users, staff, managers and families to improve the quality of life for users presenting with “challenging behaviour” and preventing placement breakdown. Discussion with participants explored the obstacles and opportunities in working productively with care homes. The HTS's potential to reduce reliance on anti‐psychotic medication was specifically highlighted. In addition to improving user and carer quality of life, outcomes of HTS intervention include a reduction in and quicker discharge from, mental health hospitals and maintaining the person in their existing setting.

The importance of including all parties – the older person with dementia, relatives, care staff and professionals – in co‐creating “solutions” was identified as one the HTS's keys to success.