Referral criteria from primary care - dementia

Referral to specialist medical service

Initial assessment and most of the time management of patients with suspected dementia is usually carried out by a general practitioner. Royal college of psychiatrists recommends referral to a specialist service in the following instances:

• diagnosis of dementia - often baseline blood tests are undertaken in primary care and then the patient is referred to a specialist (e.g. pyschogeriatrician) for formal diagnosis
• complexity or uncertainty of the diagnosis even following initial assessment or follow up
• if patient or the family request for a second opinion
• presence of significant depression and/or psychosis, especially when patients are receiving treatment or when there is acute distress in the patient
• problems with treatment or the necessity of new specific medications for Alzheimer's disease
• difficulty in patients management due to challenging or risky behaviour, multiple problems or concerns about possible abuse
• specialist opinion is required on issues such as financial capacity, driving or similar medico-legal areas (1)

Reference:

• 1. Royal College of Psychiatrists 2005. Forgetful but not forgotten: assessment and aspects of treatment of people with dementia by a specialist old age psychiatry service