Memory services pose a particular challenge for integration. New referrals have traditionally been seen by medicine for the elderly, psychiatry of old age and occasionally neurology. There have never been clear criteria to differentiate which patients should be reviewed by each service.
We hope, over the coming months, to work towards producing criteria that clearly describe which patient cohorts should be assessed by each service. This exercise should result in more streamlined assessments for patients with cognitive impairment and will facilitate the creation of a multidisciplinary memory clinic within the near future.
Once the pathway has been clarified, the referral details will be included here.
In general, memory clinic referrals should provide the following clinical detail:
1. Short & long-term memory loss
2. Problems created by memory loss (difficulties with financial affairs, medication management, maintenance of appointments etc.)
3. Perceived withdrawal, if any, from community activity
4. Behavioural & psychological symptoms (low mood, anxiety, disinhibition, aggression, hallucinations)
5. Risk behaviours (wandering, leaving cookers unattended etc)
6. Treatments offered to date & intolerances if known
7. Carer concerns - often the family member who requests the referral will not attend with the patient. It is ueful if the referral letter records their concerns