Clinical tools and resources
National dementia guidelines
Alzheimer's Australia has partnered with government and professional organisations to develop several guidelines and recommendations (focusing on the prevention/risk reduction, diagnosis, disclosure of the diagnosis, and ongoing management of dementia) and they have been developed specifically for health professionals.
- Clinical practice guidelines and principles of care for people with dementia: Recommendations. Published by NHMRC Partnership Centre for Dealing with Cognitive and Related Functional Decline in Older People, 2016
- Consensus Guidelines on Dementia in Primary Care - Due for public release in June 2016 (an update of the 2003 guidelines).
Other relevant developed or approved guidelines:
Health and aged care professionals working with people with dementia and their carers and families should refer to the following National Health and Medical Research Council guidelines:
- An ethical framework for integrating palliative care principles into the management of advanced chronic or terminal conditions (2011) - Reference number - REC31
- Guidelines for the management of absolute cardiovascular disease risk (2012) - Reference number - EXT 10
- Smoking, Nutrition, Alcohol and Physical Activity (SNAP) - A population health guide to risk factors in general practice (RACGP)
Delirium Clinical Care Standard
The Delirium Clinical Care Standard and accompanying resources provide guidance to consumers, clinicians and health services on delivering appropriate care to people at risk of, or with, delirium.
Published by the Australian Commission on Safety and Quality in Health Care. Endorsed by Alzheimer's Australia.
Building Dementia Practice in Primary Care Program
The 'Building Dementia Practice in Primary Care' Practice Guide has been developed as part of a national project to promote the timely diagnosis of dementia in general practice. The guidelines support an evidence-based practice improvement approach to supporting people living with dementia, as well as their family and carers.
The guidelines are intended for general practice teams (including general practitioners and other non-clinical staff) to build skills, confidence and capacity within the clinic to support a timely diagnosis of dementia. The guidelines are a set of performance indicators that support best practice dementia care and are presented as four steps toward building dementia practice in primary care:
Step 1- Building dementia knowledge in primary practice
Background information, prevalence, building knowledge in the practice, information and health promotion, practice examples, self-assessment
Step 2 - Building towards dementia diagnosis
Case finding, screening, assessment, tools, practice examples, self-assessment
Step 3 - Building an approach to dementia support
Building an approach to dementia support, communication, driving, behaviour support, CALD backrounds, diversity, care planning, community partnerships, practice examples, and self-assessment
Step 4 - Building sustainable dementia practice
Business model, working collaboratively with the practice, nurse led strategies, exploring potential models of dementia practice (flow charts), MBS and funding dementia support, developing dementia networks, practice improvement template
PLEASE DOWNLOAD YOUR FREE RESOURCE/STARTER KIT HERE
- For training of general practice nurses/general practice teams, please go to: APNA website
- For more information, email our Primary Care Engagement Officer
- Or visit Useful resources and tools
Clinical resources for general practice
- General Practitioner Dementia Management/Care Plan - download doc here
- Practice billing/MBS items - MBS Fee Schedule/patient billing - Check updated MBS list and rebates via www.mbsonline.gov.au & MBS billing - assessment and management of dementia
- APNA online training - www.apna.asn.au
- Alzheimer's Australia (VIC) service provider referral form
- Dementia and chronic conditions toolkit
- Driving and dementia toolkit for general practice
- Dementia practice guidelines
- Disclosure of a dementia diagnosis - disclosure and discussion of a diagnosis of dementia is an ongoing process that is typically addressed during multiple office visits.Guidelines coming soon
- Online video series for general practice
- Your Brain Matters
- Good Dementia Care in General Practice (Resource Sheet)
- Dementia Risk Reduction - information for general practitioners, practice nurses and health professionals
- Dementia Collaborative Research Centre (DCRC) - The DCRCs are a dementia research network across three centres in Australia.
- RACGP Medical care of older persons in residential aged care facilities (Silver Book) 2006
- Free Practice Resource Kit
- BPSD Quick Reference Cards
- Start to Talk (advanced care planning)
- Timely Diagnosis - Can we do better? A report from Alzheimer's Australia (2011) (Phillips, Pond & Goode)
- HealthPathways - The HealthPathways Community is a collaborative of all organisations implementing HealthPathways with links to specific Australian HealthPathways websites.
- Online Pathways For Dementia Care (2015) - Australian Family Physician
- Risk Reduction Health Professionals
- RACGP Submission to the House of Representatives Standing Committee on Health and Ageing - Inquiry into dementia early diagnosis and intervention 9 May 2012
Alzheimer's Australia (VIC) tools and resources:
Dementia risk assessment:
Half of Australian adults remain unaware of the potential for dementia risk reduction. Many patients may feel that memory loss and dementia are inevitable parts of ageing. This is not the case.
While there is no cure for dementia, an important strategy for reducing the risk of dementia is to work with patients to address modifiable risk factors.
General practitioners, general practice nurses and other primary care professionals can help their patients (with or without a family history of dementia) take proactive steps to protect their brain health and reduce their risk of developing dementia.
Patients aged 40 years and over (midlife) should routinely (as part of their 45-49 plus health check) be checked for dementia 'risk factors' for:
- Vascular disease - hypertension, dyslipidameia, diabetes
- Chronic disease - smoking, poor nutrition, excessive alcohol, physical inactivity, overweight/obesity
- Psychosocial - depression, mental activity, social activity
- Other - head injury
For more information and to download your free practical guide for general practitioners (as well as for Health and Lifestyle professionals), please go to our dementia risk reduction website health professionals' page
Also available for your patients for FREE DOWNLOAD, BrainyApp - Helping our patients live a brain healthy life.
Other recommended resources:
- Targeting Brain, Body and Heart for Cognitive Health and Dementia Prevention (Paper 29) - Dr Maree Farrow & Elodie O'Connor - Alzheimer's Australia
- Smoking, Nutrition, Alcohol and Physical Activity (SNAP) - A population health guide to risk factors in general practice (RACGP)
Risk Assessment Tool
ANU Alzheimer's Disease Risk Index (ANU-ADRI) anuadri.anu.edu.au/
Researchers at the College of Medicine, Biology and Environment at the Australian National University have developed ANU-ADRI - an evidence-based, validated tool aimed at assessing individual exposure to risk factors known to be associated with an increased risk of developing Alzheimer's disease in late-life, that is, over the age of 60 years.
The ANU-ADRI is intended to provide a systematic individualised assessment and report on Alzheimer's disease risk factor exposure. It may be useful for individuals who wish to know their risk profile and areas where they can reduce their risk, as well as be useful tool for clinicians who would like their patients to record their current risk profile for discussion at their next medical appointment. The ANU-ADRI is also used in research projects that aim to evaluate methods of reducing risk of Alzheimer's disease. For more information.
Dementia and driving information kit
Health professionals have a number of important roles to play in supporting drivers with dementia and their families and carers.
- assessing a person's fitness to drive
- advising drivers of the impact of their medical condition
- advising drivers of their responsibility to report their condition to their state or territory driver licensing authority
- treating, monitoring and managing a person's condition with ongoing consideration of their fitness to drive
- reporting to the driver licensing authority regarding fitness to drive in accordance with legal requirements, public safety and ethical considerations, and
- providing advice and support to drivers with the transition to stopping driving and finding ways to stay active, mobile and connected.
- Driving and dementia video
- Conversations about dementia and driving for health professionals and clinicians Information Sheet
- Dementia and driving pathway for clinicians and health professionals - Quick Reference Card
For more, please visit Health Professionals
Online video seminar series for general practice
The Online Video Seminar Series for General Practice is an online educational video series for those working in general practice. The videos each deliver high quality, independent, evidence-based, industry expertise and information about dementia in a dynamic, engaging and enjoyable way; all while adding significant benefit to day-to-day clinical practice.
Topic 1: Debunking dementia myths (presented by Associate Professor Michael Woodward)
Topic 2: Detecting dementia in general practice (presented by Victorian GP, Dr Malcolm Clarke)
For more information please contact Primary Care Engagement Officer by email:
On My Mind High Quality Care
Dementia and delirium in acute care
Dementia care in hospitals needs to be improved to ensure that people living with dementia, their carers and families can expect to receive care of the highest quality.
Any person going into hospital can find the experience stressful. For a person with a cognitive impairment - who may be having difficulty with their memory, thinking or communication - the experience can be overwhelming.
The Australian Commission on Safety and Quality in Health Care acknowledges that patients with cognitive impairment need extra care and supervision to stay safe during their hospital admission. People with dementia are more likely to experience falls, sepsis, pressure ulcers, fractures and delirium while in hospital (resulting in a five-fold increase in mortality rates).
Current national/state-based programs/initiatives
There is potential to improve the ability to identify or respond appropriately to people with dementia. Below are some examples of state-based and national programs. Essentially, the programs share common goals such as to:
identify and manage dementia at hospital admission and plan for discharge from the outset
involve family carers in the care and support of patients
train staff to better understand dementia and communicate more effectively with people with dementia
use alternatives, such as psychosocial interventions, to the use of antipsychotic medication and sedatives
adapt the hospital physical environment to reduce distractions and help orientate patients with dementia
- reduce avoidable hospital admissions.
The Dementia Care in Hospitals Program (DCHP)
This was developed in 2004 by Ballarat Health Services, as an 'all of hospital' education program to improve communication with and awareness of patients with cognitive impairment linked to a bedside alert (called the 'Cognitive Impairment Identifier ' or 'CII').
In 2014, the Commonwealth Department of Social Services (DSS) supported a grants application for the DCHP to be further rolled out at a national level. Canberra Hospital is one of four hospitals along with hospitals in South Australia, Western Australia and Tasmania to be selected as national partners with Ballarat Health Services to implement and evaluate the DCHP. For more information and updates about the Dementia Care in Hospitals Program, please visit BHS.
The TOP5 Program is an innovative program, developed by Central Coast Local Health District in NSW that helps personalise hospital care for patients with memory and thinking problems. Top5 is an opportunity for hospital staff to discuss and acknowledge a carer's unique expertise and knowledge of the patient/client in terms of communication and behaviour, and incorporate their experience into the care being provided. From the discussion, five strategies are identified and written onto the TOP5 form and used to address the care needs of the patient/client during their hospital admission/stay (i.e. to settle, stay calm and receive the best care possible).
The ASET Program
The emergency department based Aged Care Services in Emergency Team (ASET) in NSW offers help with screening and assessing cognitive impairment, determining care needs and planning and ensuring the person has a seamless transition between health/care facilities.
Cognitive Care Program
Cognitive impairment including delirium or dementia are common among older people admitted to hospital but are frequently missed or misdiagnosed increasing their risk of harm. The Caring for Cognitive Impairment campaign is about improving our knowledge and care practices, providing better outcomes for patients, hospitals, staff and loved ones, and reducing the risk of harm in hospitals.
Other useful resources:
- Australian Institute of Health and Welfare (AIHW) and Alzheimer's Australia (2013) - Dementia care in hospitals: Costs and Strategies
- Hospital Care for people with dementia Conversations - Alzheimer's Australia SA (March 2015)
- Dementia Care in Hospital Symposium
- Australian Commission on Safety and Quality in Health Care
- A better way to care: Safe and high-quality care for patients with cognitive impairment (dementia and delirium) in hospital
- A better way to care: Safe and high-quality care for patients with cognitive impairment (dementia and delirium) in hospital - Actions for Clinicians