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Open referral policy within a nurse-led memory clinic: patient demographics, assessment scores, and diagnostic profiles

Published online by Cambridge University Press:  08 December 2014

Melinda Minstrell ,
Michael Bentley Open the ORCID record for Michael Bentley [Opens in a new window] ,
Hazel Bucher ,
Martin Morrissey ,
Carl Higgs ,
Andrew Robinson  and
Christine Stirling
Melinda Minstrell
Affiliation:
Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania 7001, Australia
Michael Bentley
Affiliation:
Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania 7001, Australia
Hazel Bucher
Affiliation:
Department of Health and Human Services, Tasmania Older Persons Mental Health, 90 Davey Street, Hobart, Tasmania 7000, Australia
Martin Morrissey
Affiliation:
Department of Health and Human Services, Tasmania Older Persons Mental Health, 90 Davey Street, Hobart, Tasmania 7000, Australia
Carl Higgs
Affiliation:
Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania 7001, Australia
Andrew Robinson
Affiliation:
Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania 7001, Australia School of Health Sciences, University of Tasmania, Hobart, Tasmania 7000, Australia
Christine Stirling*
Affiliation:
School of Health Sciences, University of Tasmania, Hobart, Tasmania 7000, Australia
*
Correspondence should be addressed to: Christine Stirling, Associate Professor, School of Health Sciences, University of Tasmania, Private Bag 135, Hobart, TAS 7000, Australia. Phone: +61-3-6226-4678; Fax: +61-3-6226-4690. Email: [email protected].
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Abstract

Background:

Memory clinics, typically led by multidisciplinary teams and requiring health professional referral, are one means of providing diagnosis and care coordination for dementia. Nurse-led clinics may provide an effective and alternative means to dementia diagnosis, and open referral policies may minimize existing barriers to accessing a diagnosis, but evidence is needed.

Methods:

Patients attending a one-day per week nurse-led memory clinic over a 25-month period during 2011–2013 (n = 106) completed comprehensive cognitive assessments and were diagnosed by an aged care nurse practitioner. Descriptive statistics detail the demographics, assessment scores, and diagnostic profiles of patients. Comparable data from published literature was identified, and the differences were analyzed qualitatively.

Results:

One hundred and six patients were assessed with the key differences from other data sets being history of falls more common, higher mean Mini-Mental State Examination scores, and fewer dementia diagnoses. Sixty-four patients (60%) were self-referred to the nurse-led memory clinic, of which 19 (30%) were diagnosed with mild cognitive impairment (MCI) or dementia. Overall, forty-eight patients (45%) received diagnoses of MCI or dementia.

Conclusions:

An open referral policy led to a high proportion of patients being self-referred, and nearly a third of these were diagnosed with cognitive impairment or dementia. Open referral policies and nurse-led services may overcome some of the barriers to early diagnosis that are currently experienced. Considering an aging population worldwide and the associated increases in cognitive impairment, which benefits from early identification and intervention, this paper provides an alternative model of nurse-led assessment.

Keywords

memory clinicnurse practitioneropen referral policynurse-led clinicself-referraldementia
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 6 , June 2015 , pp. 967 - 979
Copyright
Copyright © International Psychogeriatric Association 2014 

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