Memory Assessment & Support Clinic

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Presentation by Caroline Walshe on Memory Assessment and Support Clinic - presented at the Nursing Showcase in 2016 at St Mary's Campus, Phoenix Park, Dublin

Health & Medicine

Caroline Walshe
Clinical Nurse Manager
St Mary’s Day Hospital

Memory Assessment & Support
Clinic (MASC)
Recognition that no comprehensive service for older
adults with a memory or cognitive problems
Recognition no support service for families and carers
MASC will fill this void.
New Clinic commenced February 2016
Multidisciplinary team approach
Referral criteria
Adults over 65 years with memory/cognitive problems
Letter of referral from GP, A&E other Medic

Assessment Process
Appointment offered to attend for assessment which may
be over two to four visits
Visit One
Nursing
Comprehensive Geriatric Assessment (CGA) - Nursing
Assessment
Cambridge Behavioural Inventory-Revised CBI-R (For
Carer)
Routine Blood screen

Assessment Process
Medical
CGA- Medical Assessment
CBI-R reviewed
Cognitive subsection of CGA
Other aspects of CGA
Clinical Examination
Follow up
Refer to OT for formal cognitive and functional assessment
Referral for brain imaging- CT/MRI/Other
Refer to other disciplines- PT/CNS-incontinence, diabetes,
audiology, tissue viability

Assessment Process
Visit Two
Occupational therapy initial interview (+/-
cognitive assessments)
Other Assessments (as necessary)
Physiotherapy CNS-incontinence, diabetes,
audiology, tissue viability
Visit Three
Further Occupational Therapy assessment (as needed)

MDT Meeting
Discussion with all team members on findings as per MASC checklist
Findings from brain imaging, bloods and other tests:
Findings from CBI-R/subjective opinions from family/carers:
Findings from cognitive and functional assessment
Diagnosis determined with clarification of stage:
Brief outline of terminology used with patient/ family and who
information was given to:
Medication commenced (type and dosage)
Other disciplines involved:
Outline any discussion regarding legal issues/future planning
(EPOA, Care Rep, Nursing Home, Respite, HCP, day centre etc)
Follow up plan

Outcome of Assessment
Consultant meeting with patient and/or family.
Brief Summary of conversation and terminology used
(e.g. cognitive impairment or dementia specific
subtype) outlined in MASC and in medical notes
Medication commenced, dosage documented in
medical chart and prescribed:
Acetylcholinesterase inhibitor
Memantine
Antipsychotic
Antidepressant
 Medical Social worker referral made if appropriate.

Support Clinic
Telephone follow up by dedicated nurse Caroline
Walshe.
Refer for routine medical 4/12 where appropriate
and/or
Telephone support service for patients who do not
require ongoing medical review

Support Clinic
HCP/HH/Private Care
Agency
Alzheimer’s Society
Symptoms and
Diagnosis
Support Groups
Day Care Centre
• CarersAllowance
• Dementia Advisor
Service
• Social Club
• Elder Abuse
• PHN
• Alzheimer Society Café
• Respite public/private
• Fold Telecare
• Care Representative
• Fairdeal NHSS application
• Enduring Power of Attorney
• Fold Housing
Information on relevant support services

Outcomes
Through comprehensive assessment and support
older adults with memory and cognition issues are
guaranteed a seamless service at a difficult time
Through ongoing support from the dedicated named
nurse provides the patient, family and carers with a
link which is available to them to address any
concerns
Scope for additional information and education
sessions around differing aspects of memory
impairment, cognition, dementia and Alzheimer's
Disease

Compassionate Care
Feedback to date from service users
“My sister now understands
what I have been going
through with my dad”
“I know now what is wrong
with me……. I thought I was
going mad……. I am getting
the help I need….”
“I am glad to have a
name I can call it
means a lot”
“Only for
you I’d be
lost”
I didn’t
know You
did all this
up here…..
Time Empathy
Listen
Understanding

Thank you
Caroline Walshe
St Mary’s Day Hospital
Ph 01 6250544

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