[P3–501]: DEMENTIA DIAGNOSIS TOOLKIT: IMPROVING IDENTIFICATION OF DEMENTIA IN CARE HOMES

A significant gap remains between predicted dementia prevalence, and recorded dementia diagnoses, and is believed to be particularly high in care home settings. Currently, most dementia diagnosis occurs in memory clinics, or during hospital admission. This pilot project aimed to demonstrate the feasibility and acceptability of a previously developed diagnostic toolkit in care home settings in supporting diagnosis of dementia by healthcare professionals. GPs were contacted by care homes when individuals with cognitive difficulty were identified who lacked a diagnosis of dementia. A clinical practitioner provided an assessment using the Toolkit, and results were discussed with the patient's GP to either (a) diagnose dementia, or (b) refer on for formal memory clinic assessment. 49 referrals were received within the pilot, of which 3 were rejected as being inappropriate. 12 individuals already had a diagnosis of dementia, but this had not been communicated to care home staff. Of 26 assessments performed in the target group, 2 were identified as not having dementia and 24 individuals showed clinical features consistent with a dementia diagnosis (92%). The GP felt confident to make a diagnosis in 8/18 individuals (44%), and was hesitant in 2/18 (11%); in a further 6 individuals, the clinical practitioner felt dementia was present but had not yet confirmed the diagnosis with the GP, and 8/18 (44%) individuals had indications for specialist referral to a memory clinic. Of the appropriate referrals, improvements to care plans were made to 38/46 (83%) in follow-up discussion with the care home staff. The use of the Dementia Diagnosis Toolkit by staff not specifically trained in dementia diagnosis is feasible in a care home setting. There is a significant cohort of individuals with undiagnosed dementia in care homes, and those already diagnosed may not have had this communicated to care home staff. Improvements in care planning are frequently identified in this cohort. Care home managers are good at identifying people with likely dementia, but value formal diagnosis in this group