{"id":3837,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/dementia\/"},"modified":"2024-09-12T11:27:42","modified_gmt":"2024-09-12T10:27:42","slug":"dementia","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/mentalhealthadult\/cognitivedifficultiesadult\/dementia\/","title":{"rendered":"Dementia"},"content":{"rendered":"\n

\u200bA diagnosis of dementia is confirmed in a specialist setting, where any pharmacological treatment is also discussed and initiated.<\/span><\/p>\n\n\n\n

Please also see the Cognitive Difficulties<\/a> page for further details about assessment of capacity.<\/p>\n\n\n\n

Each HSCP arranges its own services: referrals are generally to Older People’s Mental Health teams<\/a>, for those over 65, or memory assessment centres. HSCPs also offer a variety of urgent and supportive services for those with a diagnosis of dementia, particularly for those in care homes, who are distressed or where there are behavioural difficulties. <\/p>\n\n\n\n

Donepezil, galantamine, rivastigmine and memantine prescribing are no longer covered by Shared Care Agreements (SCAs). However, the principles of the SCAs have been retained, namely that specialists will initiate prescribing, titrate doses, assess efficacy and tolerability, and undertake initial monitoring. Further details are available on the East Region Formulary Alzheimer\u2019s disease page<\/a>.<\/p>\n\n\n\n

Initial assessment<\/strong><\/p>\n\n\n\n

Please ensure that an appropriate physical examination and investigation have been undertaken, where organic disease is suspected. Where appropriate, the GP should assess for delirium – Delirium (nhslothian.scot)<\/a> – which is more common in those with dementia. <\/p>\n\n\n\n

Please also check the following – there is a dementia order set for these on GPOC\/ICE<\/em>: <\/p>\n\n\n\n