Thursday 28 November 2013

27 Awareness, Assessment and Diagnosis for Memory Problems - Limbo Time [Update 2 - 13/11/13]


As the population gets older, the numbers with dementia are growing year by year. It is also likely that current life-style choices are  affecting younger citizens who may not otherwise develop to life with a dementia as they reach any decade over say 60. [Although seniors get dementia, younger persons, say 35 years onwards, may get young onset dementia.]    

England has over 300,000 individuals living with dementia which is not diagnosed. Also, many more persons have memory problems which may have dementia-like symptoms. Nationally as a policy it is recognised that early assessment and diagnosis are important. This post addresses issues surrounding this policy. 

 The West Kent CCG has recently issued a document which says that Sevenoaks has 1840 persons with dementia.
 http://www.e-watch.co/articles.php?viewarticle=4359&UID=4272&viaNL

Please note that the reference to Sevenoaks is likely to mean that part of the Sevenoaks District within the West Kent CCG area, ie roughly 100 square km. 

Awareness and Information
The country needs its people to be able to recognise dementia-like symptoms. The reason is that those with undiagnosed dementia will be encouraged to seek assessment and diagnosis. Where dementia is not the cause of the memory problems appropriate treatment for the condition follows, eg depression, drug abuse.

To this end a million volunteers who are being recruited to become Dementia Friends.  They have attended an awareness and information session about life with dementia and will spread this information to others. 

Preparedness of Health and Care Professionals
About 12 years' ago about 50% of doctors would probably be insufficiently trained to deal with assessment of dementia. Five or six years ago 30% of doctors in London would have said the same. By today many more local surgeries have doctors, practitioner nurses, reception staff  who are alerted respond to those with memory problems. More GPs are able to confidently carry out assessments and have the back up specialists in dementia who are based in local memory clinics. 

Specialist clinical training in assessment for dementia has been commissioned by the local Clinical Commissioning Group and given to doctors. Specialist nurses in dementia are being or will be attached to each of two surgeries.

In North West Kent the Alzheimer's and Dementia Support Services (ADSS), a charity, has devised a digital dementia appraisal package for dementia asssessment by doctors who want to use it.  

Limbo Time

As the local rate of assessments rises and and the diagnostic investigations are carried there may be an unfortunate delay - a person with memory problems may have to wait for the the result. 
In some areas the delay - limbo time - is sometimes as long as three months. Given that the national target is to increase diagnoses from about 45% to 66% Clinical Commissing Groups will need to consider any need to increase resources in memory clinics.