Dementia - early identification, diagnosis and assessment

You can find resources here which discuss issues around early identification and diagnosis of dementia and provide guidance on interventions and service developments. Resources on drug treatments are also included.
 
In other sections of the website you can also:

The resources are arranged under the following headings:

Some of the resources on this page are in PDF format - see how to access PDF files.

Resources on early identification, diagnosis and assessment 

1000 Lives Plus (2010) Improving dementia care (How to guide) (PDF 1.33MB)
This guide, published as part of the 1000 Lives Plus improvement programme in Wales, is arranged according to five key drivers and describes the interventions for each driver which have been shown to be effective. One of the key drivers is improvement of memory assessment services. Examples of local practice are included.

All-Party Parliamentary Group on Dementia (APPG) (2012) Unlocking Diagnosis: The key to improving the lives of people with dementia
This report found that waiting times for memory services, which is a key component of the diagnosis process, varied across the country from just a few weeks to over a year. The average wait was reported to be at least three months. The APPG is calling for improvement of these services, with more investment, compulsory accreditation and better accountability to raise standards across the UK. Some key recommendations from the report are that there should be investment in a public dementia awareness campaign, prioritising of rates of diagnosis for public health directors, and improved support for people following a diagnosis of dementia.

Alzheimer’s Disease International (2012) World Alzheimer Report 2012: Overcoming the stigma of dementia
This report shares results from a worldwide survey conducted with people with dementia and carers on their personal experiences of stigma. The report provides information on stigma and dementia, highlights best practices in the field of dementia, and makes recommendations which could help reduce stigma. The executive summary highlights the key findings and recommendations. The full report includes quotes from carers and people with dementia, further analysis of the survey responses and a selection of essays from people with expertise and experience relevant to dementia and stigma.

Alzheimer’s Society: Symptoms and diagnosis
This section of the Alzheimer’s Society website contains information about risk factors associated with different types of dementia, memory problems, diagnosing dementia and the kinds of assessments that might be done. There is also information on what might need to be considered following a diagnosis of dementia.

NHS Information Centre for health and social care: National Dementia and Antipsychotic Prescribing Audit
The National Dementia and Antipsychotic Prescribing audit aims to gather information from primary care to establish a national picture of prescribing antipsychotic medication in people with dementia. Approximately 750,000 people in the UK live with dementia and the NHS aims to provide them with the best dementia care possible. The National Dementia and Antipsychotic Prescribing Audit plays an important part in this.

NICE Pathways: Dementia overview 
The NICE dementia pathway brings together all related NICE guidance and associated products in interactive topic based diagrams. The pathway includes sections on early identification and diagnosis and assessment.

Parliamentary Office of Science and Technology (2010) Postnote no 349 January: Diagnosing dementia (PDF 177.64KB) 
This briefing outlines current diagnostic practices, research into newer tools and service provision proposals that aim to increase early diagnosis of dementia.

RCN e-library: relecant articles - patient assessment and diagnosis  
This is a list of selected articles from a search made in British Nursing Index on dementia: patient assessment, diagnosis and memory services. There is also information on how you can do the search yourself for a more comprehensive listing.   

Royal College of Psychiatrists: Memory Services National Accreditation Programme (MSNAP)
The programme works with services to assure and improve the quality of memory services for people with dementia and memory problems and their carers. “Accreditation assures staff, service users and carers, commissioners and regulators of the quality of the service being provided”. Involving service users and carers in the programme is a priority. The resources available include the MSNAP Standards which currently cover four main domains - see MSNAP Standards. For further resources within the programme including details of the accreditation process see resources.

Social Care Institute for Excellence (SCIE): Windows of opportunity: prevention and early intervention in dementia: a tool for commissioners and providers
This resource focuses on early intervention – providing support  in a timely way at the earliest stage of dementia following diagnosis, and on prevention “which encompasses the range of interventions that prevent an escalation in need that may tip an individual into a higher or more intensive level of service”. The resource aims to offer a greater understanding of the journey through dementia looking at aspects such as transition points, harnessing personal resources, possible interventions and mapping of local assets.

SCIE Dementia Gateway: Early signs and diagnosis
'For many people who develop dementia, the early stages are hugely difficult: feelings of uncertainty, denial, confusion and a drop in self-confidence all combine to place strain on relationships and throw chaos into regular daily life'. This section looks at early signs of dementia and how getting a diagnosis of dementia can be a crucial first step in obtaining support to cope and come to terms with life with dementia.

Resources and tools on drug treatment

For further resources and guidance on the use of anti-psychotic drugs see the section on Responding to distressed behaviour.
 
Alzheimer’s Society: Treatments
This section in the Alzheimer’s Society website provides information about drug treatments that are available to alleviate some of the symptoms of dementia. It also discusses issues surrounding the use of complementary and alternative treatments.
 
NICE Pathways: Dementia overview
The dementia interventions section of the pathway includes interventions for non-cognitive symptoms and beahviour that challenges. View dementia interventions.

RCN Principles of Nursing Practice
The Principles describe what everyone can expect from nursing practice in any setting.
Principle C: Nurses and nursing staff manage risk, are vigilant about risk, and help to keep everyone safe in the places they receive health care. Details of RCN resources to support improvements in patient safety are at Principle C.

Stories and good practice examples

Practitioners have shared improvements they have made in the delivery of dementia care and services describing what changes occurred as a result of their initiatives and what they learned from the experience. The stories have been arranged according to the five key ingredients in the Commitment to the care of people with dementia in general hospitals. To read these improvement stories see Best practice examples.

Department of Health (2011) Living well with dementia: a National Dementia Strategy - good practice compendium
This good practice compendium has been compiled from across the regions to support local delivery of the national dementia strategy. It brings together practice examples on a wide range of dementia care.

Healthtalkonline
This is a database of personal and patient experiences compiled from qualitative research on different health conditions undertaken by the Health Experiences Research Group at the University of Oxford. Carers of people share their experiences on:
Diagnosis This includes: suspicions - early signs of dementia; signs of dementia; deterioration, severe dementia; making the diagnosis; tests; getting the diagnosis; genetic testing; ideas about causes of dementia)
Treatment for Alzheimer's disease Carers talk about the benefits they feel that drugs have given. Some also talk about the difficulties of obtaining drugs.

NHS Scotland: Living well with dementia
In this video which is part of the Understanding and Living with Dementia campaign in Scotland, people with dementia and their carers talk about events leading up to a diagnosis of dementia and how it has impacted on them and their lifestyles. Carers also talk about information needs.

NHS Scotland: Living well with dementia: practical tips and advice
In the same series there is also a video in which people with dementia give practical tips and advice e.g. written prompts and lists and managing activities like driving. People talk about how dementia affects them in daily life and what helps, and also about the importance of maintaining a sense of normality and routine.

Patient Voices  
The Patient Voices programme developed by Pilgrim Projects works with healthcare professionals, carers and patients to enable them to develop their own stories and narratives and is involved in ongoing research and development on the use of digital storytelling in health and social care.

SCIE Social Care TV 
Social Care TV is an online channel providing video-based training resources and general interest programmes for everyone involved in the social care sector. Relevant videos are:
Living with young onset dementia - a film highlighting the experiences of younger people being diagnosed and living with dementia and Late-onset dementia: early diagnosis and drug treatment - this case study illustrates the positive effects of an early diagnosis of dementia.

Standards

For the relevant standard statements and associated guidance see: 
 
NICE quality standards: Dementia standard
See statements 2, 3, 4, 7, and 8.
 
Scottish Government: Standards of care for dementia in Scotland
As a person with dementia:
I have the right to a diagnosis.
I have the right to access a range of treatment, care and support.

For overarching resources and resources on other specific aspects of care see Supporting people with dementia.