Consultation Three - Decision Point Two
During this consultation review the baseline information collected in the MMSE 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 Four and Detailed Assessment Consultation Five tabs for further information.
Invite carer to attend next visit independent of patient to discuss health care needs emerging from Informant package - refer to Carer / Family Consultation Four tab for further information.
Option 2: Refer to CDAMS / specialist for further assessment - go to Referral for diagnosis and management tab for further information.