Outcomes of Dementia Pathway Referrals Post Comprehensive Geriatric Assessment by a Community Specialist Team for Older Persons

Abstract

Abstract Background The Model of Care for Dementia in Ireland (2023) outlines targets and recommendations for a Dementia service. A Dementia pathway was developed from a Community Specialist Team (CST) for Older Persons service to a local Memory Clinic service and this was evaluated with reference to the model of care. Methods All adults aged ≥70 years, who received a Comprehensive Geriatric Assessment (CGA) by a CST in 2022, and were referred to a Memory Clinic service, were included. Data including dates of referral and Memory Clinic attendance, age, gender, Clinical Frailty Scale score (CFS) and diagnosis were entered into Excel. These were analysed using descriptive statistics. Results Seventy-nine patients were referred to the Memory Clinic. Twenty-eight (35.5%) attended, with 51 (64.5%) non-attendances. Twenty-seven (34%) cancelled, 13 (16.5%) did not attend, 7 (9%) died before receiving an appointment, and 4 (5%) appointments were deferred at patient request. The mean age of patients referred was 82.39 years (SD=6.876). The male to female ratio of attendees was 1:1.3 and non-attendees was 1:1.9. The median CFS score of both attendees and non-attended was 5 (range 3-7). Eight (21%) of those who did not attend had moved to long term care, representing 10% of total referrals. The median waiting time for attendees was 10.5 months (Range 2-21). Thirteen (46%) patients received a diagnosis of Dementia, 3 (11%) Mild Cognitive Impairment (MCI), 2 (7%) Acquired Brain Injury and 10 (36%) received no memory diagnosis. Conclusion This Dementia pathway does not meet target 14 of the Model of Care. The waiting times exceed 6 weeks, resulting in missed opportunities to provide supports. Timely access to the pathway and supports to attend may increase attendance. A dedicated Memory Assessment and Support Service will address this deficit.