The objective of the assessment package of consultations for a patient presenting with memory and thinking difficulties is to achieve one of four possible outcomes:
- Reassurance that dementia is not present and the investigation of other reasons for the presentation of memory and thinking difficulties e.g. anxiety, depression or other chronic illness.
- Planned review in six months because there is acknowledgement of some memory symptoms which have occurred in the setting of other significant illness or stressors e.g. hospital admission with possible delirium, which need to be managed or given time to settle before a more definitive plan occurs.
- Referral to a specialist service such as CDAMS (Cognitive Dementia and Memory Services) because there are signs and symptoms that are not clear cut or the patient is complex e.g. young age <65, mixed pathologies, rapid change, associated motor symptoms; or
- The diagnosis of dementia including the differential diagnosis of the aetiology of the dementia, be that Alzheimer's disease, vascular dementia, Lewy body dementia etc. This diagnosis will trigger a need to address the management associated with the diagnosis including decisions about, driving, legal issues such as EPOA, community based education and support (Alzheimer's Australia Vic, Commonwealth Carer Respite Services) and medication for the symptomatic treatment of dementia.
The MBS package includes all steps to diagnosis, but not all steps may be needed. The first step occurs after the concern is raised and there is a decision to pursue clarification of concern.1
|MBS Item Numbers applied to the Diagnostic Pathway for the Assessment and Management of Dementia||Published|