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Feature Article

Dementia: 14 essentials of assessment and care planning

Henry Brodaty, Michael Connors, Dimity Pond, Anne Cumming, Helen M Creasey

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Abstract

Many GPs report a lack of time and confidence in diagnosing dementia. Fourteen practical points are described to guide the assessment and care of patients with cognitive decline.

Key Points

  • Signs of possible dementia should be taken seriously; timely diagnosis is important to allow patients to be treated and patients and families to prepare for the future.
  • Take a detailed history and perform a standardised test of cognition and a mental and physical examination.
  • Diagnose the dementia cause; investigate for reversible causes and rule out other diagnoses, such as delirium, depression and drug adverse effects.
  • For patients with dementia, discuss key issues including daily living, legal and financial affairs, the transition from work and driving, and the stress on supporting carers and family.
  • Assessment should culminate in a care plan, with strategies to manage specific symptoms, support for the patient and family, regular monitoring and referrals to support groups and organisations.
  • As symptoms and challenges change over the course of dementia, the care plan needs regular review.

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