What is being done?

The Day Hospital Memory Service provides all inpatients and outpatients with access to a pathway of care that delivers a rapid and competent specialist assessment for cognitive impairment and/or dementia as part of the clinical management of long term co-morbidities.

The Memory Service includes a multi-professional team of Consultant Physicians and Geriatricians, Senior Lecturer and Honorary Senior Nurse in Geriatrics, in collaboration with Bournemouth University, Clinical Nurse Specialist in Dementia, and Senior Occupational Therapists with special interest in Cognitive Stimulation Therapy and Memory Strategy.

What is new and different?

• The Memory Outreach Service facilitates home visits by the Memory Team.
• The collaboration with Bournemouth University supports workshops and lectures on dementia, also research and publication. 
• Care planning is both needs-specific and holistic, with long term support on care planning from the Memory Team, and collaboration with CMHT and primary care.  ‘This is Me’ leaflet from the Alzheimer’s Society is incorporated in the review and assessment proforma to enhance needs-specific care planning.
• The holistic service provides access to cognitive stimulation therapy, memory strategy, speech and language therapy, balance training and falls prevention strategy by the Day Hospital Falls service or community physiotherapists.
• Referrals to clinical psychology are made in collaboration with primary care and CMHT. 
• The service is also compliant with NICE guidance TA217 for drug treatment of dementia by Consultant Geriatricians.

What difference this seems to be making

• There is an increase in the new diagnosis of dementia in the early stage and mild cognitive impairment (MCI).
• Patients who were diagnosed with delirium as inpatients are reviewed in the Day Hospital after discharge because it is just as important to know that they recover from delirium and that they do not have underlying dementia. If they continue to experience cognitive decline, it is also important to make the appropriate diagnosis of dementia in the early stage or MCI.
• Patients with MCI are offered long term follow-up and should they convert to early dementia, they are reviewed for needs specific, holistic and advanced care planning by the Memory Team.
• Patients with a dementia are also offered long term follow-up to facilitate continuing care planning by the Memory Team.
  There is ongoing evaluation and audit of the MDT memory service based on Department of Health outcome indicators, and standards from NICE guidance.

Plans for taking the project forward

• Building on the positive outcomes achieved so far, there are continuing plans to expand the MDT memory service, driven by a dedicated team of Consultant Physicians and Geriatricians with special interest in dementia.
• Continuing collaboration with Bournemouth University supports further opportunity for training and education, research and publication with the aspiration to be the centre of both clinical and academic excellence for dementia care.