assessment management and support for people living with PDF

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eplaces CG42, ESUOM41 and ESUOM40. Thisrguidelinerpar herbasisrofrQS,6randrQS7-.4rOv erview This guideline co vers diagnosing and managing dementia (including Alzheimer's disease). Itraimsrt oducedrarguidelineronrmid3lif W ho is it for? • Healt

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A bout this guideline Dementia is a t erm used to describe a range of cognitive and behavioural symptoms that canrincludermemor essingrandrcooking4rThermostrcommonrtypesrofrdementiarare rAlzheimerysrdisease2rv Arr

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H ow has it been developed? This guideline has been de veloped by a multidisciplinary guideline committee, using an e ecommendationsrinrthisrarea4rG ecommendationsrforrfuturerr esearchrz H ow does it relate to statutory and non-statutory #

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s existing legislation and guidance. It describes how services andrpr erysrChallengeronrDementiar8686rset sroutrtherUKrGovernmentysrstrategyrf orrtransformingrdementiarcarerwithinrtherUK4rTheraimsrofrtherstrategyrinclude r¥rimpr ed4rTherCar erActr867.rcr eatedrarnewrlegislativerframeworkrforradultrsocialrcare2rDementia rassessment2rmanagementrandrsuppor ersrzNG'?ifi© NICE 2023

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and also giv es carers a legal right to assessment and support. R elevant legislation and statutory guidance • NHSrEnglandrz867,ifirAccessiblerInf ormationrStandardr¥rCar erActr867.r¥rHealt tmentrofrHealthrz867.ifirCarerActr867. rStatutoryrGuidancerforrImplementationr¥rDepar tmentrofrHealthrz867.ifirPositiverandrProactiverCare rReducingrtherneedrforrr estrictiverinterventionsr¥rHealt

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P erson-centred care This guideline off ers best-practice advice on care and support for people living with dementiarandrt t r¥rt heirrfamiliesrandrcarersr¥rt heirrinput4rDementia rassessment2rmanagementrandrsuppor ersrzNG'?ifi© NICE 2023

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R ecommendations P eople have the right to be involved in discussions and make informed decisions aboutrt heirrcare2rasrdescribedrinrNICEysrinf e4r

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xplainsrhowrweruserwordsrtorshowrtherstr eguarding4rNICErhasralsorpr oduced r¥rarguidelineronrdecisionrmakingrandrmentalrcapacity2rwhichrpr ovidesrfurtherrdetailsronrho hrsevererdementia4r 1.1 I nvolving people living with dementia in !!:#":" : :I nvolving people in decision-making 1 .1.1 Encourage and enable people living wit h dementia to give their own viewsrandropinionsraboutrt heirrcare4r1 .1.2 If needed, use additional or modified wa ys of communicating (for e .1.3 Consider using a structur ed tool to assess the likes and dislikes, routines Dementia rassessment2rmanagementrandrsuppor ersrzNG'?ifi© NICE 2023

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and personal hist ory of a person living with dementia. Pr oviding information 1 .1.4 Pr ovide people living with dementia and their family members or carers zasrappr herstagerofrtheirrcondition4r1 .1.5 Be awar e of the obligation to provide accessible information as detailed inrt herNHSrAccessiblerInf ormationrStandard4rF orrmorerguidanceronrpr herNICErguidelinesronrpatientre xperiencerinradultrNHSrservicesrandr peopleysre 1 .1.6 A t diagnosis, offer the person and their family members or carers (as appr opriateifiroralrandrwrittenrinformationrthatrexplains r¥rwhatrt ogressesr¥rwhichrhealt erandrhowrtorcontactrthemr¥rifrappr

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heyrar erworkingrorrlookingrforrworkr¥rho wrtherfollowingrgroupsrcanrhelprandrhowrtorcontactrthem r- localrsuppor trgroups2ronlinerforumsrandrnationalrcharitiesr- financialrandrlegalradvicerser vicesr- adv ocacyrservices4r1 .1.7 If it has not been document ed earlier, ask the person at diagnosis: Dementia rassessment2rmanagementrandrsuppor ersrzNG'?ifi© NICE 2023

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• f amilyrmembersrorrcarersifir¥rwhatrinf .1.8 Aft er diagnosis, direct people and their family members or carers (as appr ecommendationsr74947randr74948ronrcar ercoordinationifi4r1 .1.9 F or people who do not want follow-up appointments and who are not usingrot erdate4r1 .1.10 Ensur e that people living with dementia and their carers know how to get mor .1.11 T ell people living with dementia (at all stages of the condition) about r dvance care planning 1 .1.12 Off er early and ongoing opportunities for people living with dementia and peoplerin volvedrinrtheirrcarerzseerrecommendationr7474?ifirtordiscuss r¥rt airsrdecisionsifir¥ranradv egardingrtheirrfuturercarer¥radv ancerdecisionsrtorrefusertreatmentrDementia rassessment2rmanagementrandrsuppor ersrzNG'?ifi© NICE 2023

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• t ementsrandrdecisionsrtheyrhavermade4r1 .1.13 A t each care review, offer people the chance to review and change any adv ancerstatementsrandrdecisionsrtheyrhavermade4r1.2 D iagnosis I nitial assessment in non-specialist settings 1 .2.1 A t the initial assessment take a history (including cognitive, behavioural andrpsy eifi r¥rfr • ifrpossible2rfr 1 .2.2 If dementia is still suspect ed after initial assessment: ¥rconductrarph ysicalrexaminationrand • under erdeclinerand • usercognitiv ertesting4r1 .2.3 When using cognitiv e testing, use a validated brief structured cognitive instrumentrsuchras r

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• t herMini3Cogr¥rT estrYourrMemoryrzTYMifi4r1 .2.4 Do not rule out dementia solely because t he person has a normal score onrarcognitiv erinstrument4r1 .2.5 When taking a hist ory from someone who knows the person with suspect .2.6 R eferrt yrclinicrorrcommunityroldragerpsychiatryrserviceifirif r¥rr erimpairmentrfromrmedicinesrassociat vestigatedrand • dementiarisrstillrsuspect ed4r1 .2.7 If t he person has suspected rapidly-progressive dementia, r eferrt hemrtorarneur .2.8 F or more guidance on assessing for dementia in people with learning disabilities2rseert herNICErguidelineronrmentalrhealt hrproblemsrinrpeoplerwit hrlearningrdisabilities4r D iagnosis in specialist dementia diagnostic services 1 .2.9 Diagnose a dementia subtype (if possible) if initial specialist assessment zincludingranrappr .2.10 If Alzheimer's disease is suspect ed, include a test of v erbalrepisodicrmemor yrinrt herassessment4rDementia rassessment2rmanagementrandrsuppor ersrzNG'?ifi© NICE 2023

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1 .2.11 Consider neur opsychological testing if it is unclear: ¥rwhet • whet • whatrt hercorrectrsubtyperdiagnosisris4r1 .2.12 Use v alidated criteria to guide clinical judgement when diagnosing dementiarsubtypes2rsuchras rquotesdbs_dbs46.pdfusesText_46

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