GP dementia care plan

Carers of people with dementia - Assessments and care plan

Dementia Gp Guidance By Dr A Burns . Care Plan Template Nursing For Dementia Mental Health Download . Dementia Diagnosis Checklist For Gps . Care Plan Template Nursing For Dementia Mental Health Download . Http Www Yhscn Nhs Uk Media Pdfs Mhdn Dementia Primary 20care Dqt 20update 202017 Dementia 20emisweb 20implementation 20guide 20v2 0 Pd A person-centric dementia care plan might, for example, be based upon an assessment of the individual's needs and behaviours, and the circumstances that trigger them, over a typical 24-hour period Dementia Care in General Practice - GP Facilitator Workshop. In 2015, the PREPARED team, developed two evidence-based evaluated and accredited dementia workshops which were run by a team of skilled GP facilitators based around Ireland to GPs and practice staff in their practices. These practice-based workshops were focused on diagnosis and post. If there is dementia the antipsychotic of choice is risperidone, which is licensed for BPSD at a dose of up to 1mg twice daily for up to 6 weeks. This drug (or any other antipsychotic) must be used with extreme caution as all antipsychotics have been shown to increase risk of CVA in this patient group. Patients must be regularly reviewed and treatment beyond 6 weeks should not occur without full, documented review of ongoing clinical nee GPs and practice nurses GPs often have a long-term relationship with their patients, including those with serious chronic disease and life-limiting illness such as Alzheimer's disease and other forms of dementia. As a GP, you can play a vital role in helping your patients to understand their medical condition and to plan for the future, including possible choices they may have to make about.

Nursing analysis for dementia together with nursing care plan and interventions. Impaired reminiscence associated to This nursing care plan is for sufferers who're experiencing wandering attributable to dementia. In keeping with Nanda the definition of wandering is the state by which an care plans of illness situations, nursing analysis, nursing discharge plan 01 Dementia Care [ possible dementia by care home staff provided to GP lead Clinical assessments by GP lead using DiADeM tool Outcome of clinical assessment confirmed with care home for addition to resident's care plan Written outcome of clinical assessment sent to GP surgery for coding on the GP notes for the resident Request to consider future residents.

How the GP can support a person with dementia Alzheimer

Mental Health Care Plan Templates - 17 Free Word, PDF

This guide is aimed at primary care and commissioners, particularly GPs, who provide care plan reviews. It is designed to help improve care planning in dementia by supporting a standardised approach, highlighting good practice, ensuring alignment with relevant cross-condition care plans and help to reduce local variation in the process Wales Mental Health in Primary Care (WaMH in PC), a special interest working group of RCGP Wales, has developed, with funding from Welsh Government, a FREE interactive 'Managing Dementia in Primary Care Training Resource, aimed at supporting Primary Care Teams to deliver the best quality care to patients with dementia

Daily Care Plan Alzheimer's Associatio

  1. Guidance for GP practices on Anticipatory Care Planning conversations with people with dementia living in the community during COVID-19 (August 2020
  2. staff call patient / carer prior to appointments. Community Engagement
  3. This case study forms part of the Dementia: Good Care Planning guide and provides example QOF annual review templates available for EMIS Web and SystmOne practices and an example questionnaire for people living with dementia and carers as part of the annual review
  4. GPs, who provide care plan reviews. It is designed to help improve care planning in dementia by supporting a standardised approach, highlighting good practice, ensuring alignment with relevant cross-condition care plans and help to reduce local variation in the process. N/A NHS England February 201
  5. A care plan is a management plan of a chronic condition which the doctor manages over a 12 month period. During this 12 month period, the doctor will set particular goals and targets that they want the patient to achieve which is then communicated with the patient so they are fully aware of how they will achieve these goals

Dementia is an increasingly common condition in the community. On average, every general practitioner in Australia will see three new cases each year. There are strong reasons for making an early diagnosis of dementia, as this may enable families to plan ahead and to institute management that could reduce cognitive impairment and slow disease progression. | RACG In general, if a GP has contributed to a multidisciplinary care plan prepared by the residential aged care facility (MBS item 731), the resident with the care plan is eligible for Medicare rebates for up to five individual allied health visits per calendar year (the period of time between January 1 and December 31) Dementia care is a priority for all long term care providers, including assisted living communities (ALC).1 According to the National Center for Health Statistics, it is estimated that almost 40% of residents in residential care have Alzheimer's disease or other dementias (Harris-Kojetin, Sengupta, Park-Lee, & Valverde, 2013). Th Maximum of 1 per client in a calendar year. Item 721 Preparation of a General Practice management Plan: Item 723 Coordination of Team care Arrangements; Item 732 Review of a GP Management Plan and/or Coordinate a review of Team Care Arrangements; Item 731 Contribution by a GP to a MD care plan for a patient in a RACF General practice systems General practice culture Patient diagnosis, care and support Physical environment Introduction GP practices open the door to diagnosis, information, support, planning, and ongoing management and review for people with dementia and those who care for them. This support is vital. For people with dementia, day-to-day task

People with dementia, carers and staff in GP practices have worked together to co-design and develop this guide. The checklist covers: General practice systems General practice culture Patient diagnosis, care and support Physical environment Introduction GP practices open the door to diagnosis, information, support, planning, and ongoing. DelpHi-MV is a GP-based cluster randomized controlled intervention trial. DelpHi-Intervention aims to provide optimum care by integrating multi-professional and multimodal strategies to individualize and optimize treatment of dementia within the framework of the established healthcare and social s Primary care nurses can assist General Practitioner's to identify cognition concerns and support patient health self-management for those experiencing cognitive impairment or dementia. This support may lead to more appropriate care and better health outcomes for this group. Consequently, there is a need to identify the role of the primary care nurse in dementia care provision, nurse. dementia not able to be met by the General Practitioner (GP) alone [1, 8, 12]. Early identication of cognitive changes and individu-alised care plans should reect an understanding of how the person's cognition may be inuencing their self-care and adherence to health management strategies [13]. Whole-person dementia care that includes medical Institutional care: When the hom-based care is not feasible or unavailable, the person with dementia may need instituitional care with provision for assisted living. Short-term hospitalization : This is often required when there is a medical or surgical morbidity which often cannot be handled in ambulatory care settings

GP annual review with a person with dementia Alzheimer's

Care or critical pathways. The term dementia care pathway has multiple and overlapping meanings. This review distinguishes four meanings: 1) a mechanism for the management and containment of uncertainty and confusion, useful for the professional as well as the person with dementia; 2) a manual for sequencing care activities; 3) a guide to consumers, indicating eligibility for care. A dementia care pathway describes the care a person receives from the moment they consult their GP about short-term memory loss and then receive a dementia diagnosis, right up until the very end-of-life. In 2009, the UK Government's ' Living well with dementia: a national dementia strategy ' provided a new strategic framework for making. Primary care GP data shows that, in 2018/19, 78% of people diagnosed with dementia had a face-to-face care plan review in the preceding 12 months. Around 1 in 5 people don't have their condition reviewed, and don't have the opportunity to make changes to the care or treatment they receive Dementia Assessment Referral to GP Form A diagnosis provides a gateway to ensure that people with dementia in care homes receive person-centred care. DeAR-GP provides a valuable resource to enable better integration between health and social care support; assisting care home staff, GPs and importantly those living with dementia an

Dementia Care Plan Template Gp - SHAPE Templat

Dementia, delirium, tobacco use disorder and mental retardation are not regarded as mental disorders for the purposes of the GP Mental Health Care items. (Better Access to Psychiatrists 1.8) Preparing for your appointment. Before you see the GP to talk about your mental health concerns it is a good idea to prepare for your appointment. What you. Activity Work Plan 2019-2022: Core Funding GP Support Funding This Core Activity Work Plan template has the following parts: and general practice through the commissioning of a range of Allied Health Hunter New England Integrated Care Alliance CF2.06 Dementia Hunter Dementia Alliance and Central Coast Dementia If you think you or someone you care about may have dementia, it is important to see a GP for an assessment as soon as possible. The benefits of an early diagnosis include some peace of mind in knowing what is going on, the opportunity to find out more about the condition, access to services and support and the ability to plan for the future

Longbridge Deverill Nursing Home Services - Equality Care

Example of a Dementia Plan - The Good Care Grou

  1. GP Management Plans and Team Care Arrangements If a patient has a chronic medical condition, they may be eligible for services under a General Practitioner Management Plan (GPMP) or Team Care Arrangement (TCA). Chronic medical conditions are those that have been, or are likely to be, present for at least 6 months..
  2. Discussing future care is difficult due to uncertainties about the future and the decisional capacities of people with dementia. Based on the facilitators, we recommend that GPs use a timely and goal-oriented approach and involve all stakeholders. ACP discussions should focus on the ability of peopl
  3. is chaired by the Minister of State for Care, and includes delivery partners from across Government, health, social care, research and the charitable sector. 1.5 In the Dementia 2020 Challenge: Implementation Plan, we committed to conduct a Review during 2018 to assess whether we have achieved the actions included in the plan
  4. Patients with Alzheimer's, subcortical vascular dementia, frontotemporal dementia and dementia with Lewy bodies (DLB) typically experience a continual, often slow, decline in their cognitive function allowing a degree of anticipatory care planning by the patient, family and the health and social care team

Cara Friend Royal College of GP's allows those who provide dementia services to plan for future service development. The language in the Care Pathway is quality dementia care being delivered to all people with a dementia at the right time, in the right place and by the right. The number of older people, including those living with dementia, is rising, as younger age mortality declines. However, the age-specific incidence of dementia has fallen in many countries, probably because of improvements in education, nutrition, health care, and lifestyle changes. Overall, a growing body of evidence supports the nine potentially modifiable risk factors for dementia modelled.

Supported Decision-Making in the National Plan on Elder

Recorded Dementia Diagnoses - February 2021. We collect and publish data about people with dementia at each GP practice, so that the NHS (GPs and commissioners) can make informed choices about how... 18 March 2021 This guidance outlines the dementia care pathway and associated benchmarks to support improvements in the delivery and quality of care and support, for people living with dementia and their families and carers. It accompanies and builds upon a shorter guide published by NHS England.12 While good dementia care should be seen acros The rate of dementia overall is 10% in those aged >75 years. Dementia is common in residents in residential aged care facilities (RACFs), and the rates of prevalence are often quoted to be above 50%. 3 However, 70% of people with dementia live in the community. In the community, the spectrum of dementia is more at the mild-to-moderate level, where a few people with severe dementia in the.

During a follow-up appointment with a GP, or other healthcare professional, they'll check how the dementia is progressing and if you have any new care needs. Ongoing appointments are also a chance to talk about your plans for the future, such as Lasting Power of Attorney , to take care of your future welfare or financial needs, or an advance. The National Dementia Strategy (DH, 2009) details a five year plan to radically transform the quality of care for PWD and their carers'. The government pledged an additional £150 million investment over the first two years, to support local services in implementing the plan 2.2. Community-based, collaborative DCM versus usual care. DCM is a model of collaborative care, aiming to support PwD and their caregivers through coordination and management of optimal treatment and care .The intervention was developed according to current guidelines , , , , targeted at the individual participant level, delivered in participants' homes by nurses with dementia-specific.

Dementia care symptoms: Signs include uncontrolled

Dementia Care in General Practice - GP Facilitator Worksho

Add to Dementia Register zzPrepare care plan and treat. 6 Dementia Diagnostic Pathway Guidance Notes Defining Dementia Dementia is a syndrome which may be caused by a number of illnesses where there care by GP and Community Mental Health Team may be more appropriate. A multi Hospital admissions for Ambulatory Care Sensitive Conditions (ACSCs) are potentially avoidable. Dementia is one of the leading chronic conditions in terms of variability in ACSC admissions by general practice, as well as accounting for around a third of UK emergency admissions. Using Bayesian multilevel linear regression models, we examined the ecological association of organizational. The care coordinator develops a care plan with the person with dementia and their carer. The care coordinator organises referrals with external services and also reports to the person's GP. Regular ongoing reviews of the person's and carer's needs are held at multidisciplinary meetings GPs do not have to complete another GP Mental Health Treatment Plan using one of the new items (2700, 2701, 2715 or 2717) if they are already managing a patient's care needs using one of the former GP Mental Health Treatment Plan items (items 2702 and 2710) and this plan is still appropriate to the patient's needs

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3) A Suite of Clinical templates to support GP Care Planning ( QOF) and aspects of care of patients living with Dementia to allow uniform coding and raise the standards of care These resources can be used by individual practices or by CCGs to look at the needs of the CCG population Dementia (mate korongenge) is a term used to describe symptoms that occur when there is a decline in brain function. This may include problems with memory, thinking, behaviour and the ability to perform daily tasks. If you're becoming increasingly forgetful, particularly if you're over the age of 65, it may be a good idea to talk to your GP about the early signs of dementia

The NES (2009) guide notes that A person with dementia frequently enters into a long 'flat' period after diagnosis because of the belief that little will - or can - be done for them in these early stages.In fact, the potential for help through early intervention is high. Early intervention - including providing good information, support and care - is designed to help a person. In January 2019, a five-year GP contract framework was agreed that was intended to stabilise general practice and allow it to be a key vehicle for delivering many of the commitments in the NHS long-term plan and provide a wider range of services to patients. A voluntary extension to the contract, known as a directed enhanced service (DES), was developed that would be offered to general. The care you receive will include the palliative care you have probably received at an earlier stage of dementia, alongside end of life care. Palliative care is for anyone diagnosed with a life-limiting illness. It involves making you comfortable by managing pain and other distressing symptoms

General Practitioners & GP Practice Nurses Dementia

guidance on developing anticipatory care plans for people with dementia, and links to information for people on ACP in the context of COVID-19 published by NHS Inform. These resources are intended to be used with health and social care staff, and are not designed for use by individuals and their families without support and guidance Dementia: Scenario: Follow up of confirmed dementia in primary care. Scenario: Follow up of confirmed dementia in primary care. Last revised in May 2021. Covers the ongoing care and support of people with dementia and their family/carers in primary care, management of challenging behaviour related to dementia, and when to seek advice or refer a.

Nursing Care Plan For Dementia Template Busines

A diagnosis helps the person with dementia and their family to get the best treatment, support and plans in place as soon as possible. This includes looking at finances, legal issues and making decisions for the present and the future. A timely diagnosis can help the person stay well for longer by increasing their awareness of the condition and. Guidance and services. Books on prescription for dementia (WHC/2018/031) Guidance for GPs on books available for people living with or helping someone with dementia. Dementia care register guidance (WHC/2015/004) Guidance for primary care health professionals to improve early diagnosis of dementia. Integrated care fund: 2021 to 2022 guidance The continued service development is led by a Dementia nurse specialist: Sister Yvonne Weldon. Dementia care at Luton & Dunstable Hospital aims to provide a person centred approach to the person with Dementia when they attend the hospital. We also aim to offer support and relevant sign posting to the carers of people living with dementia

Dementia GP Guidance by Dr A Burns 1. 1 GP Guidance Core elements of a care plan Source - National draft Guidance A dementia care plan should cover: Dementia Care Plan Template.pptx D Diagnosis review Just check the diagnosis given is correct and confirm the patient's (and family and carer's) understanding of it General practice often acts as a gatekeeper for key aspects of care for people with dementia. For many it is the GP practice that opens the door to information, support and planning; GPs often provide the information and signposting needed to access support; and GPs hold responsibility for care plans and reviews for ongoing management Dementia Family Support Service referral form to be added to EMIS at Practice DC 30/03/18 2.5 The GP Practice is part of a dementia friendly community Process for missed appointments by dementia patients is added to practice DNA policy DC 20/04/18 3.2 Care plans are integral to overall care of the patient Share Herbert Protocol informatio Ageing and includes a significant focus on dementia. In 2015, HIN worked with care workers in care homes to co-design DeAR-GP (Dementia Assessment Referral to GP) which supports care workers in care home settings to identify people who are showing signs of dementia and refer them to their GP for review and a possible diagnosis

NHS to discontinue dementia diagnosis payments to GP

Secondary care prescribers: Communicate drug changes to the GP. Provide a reason for each prescription. Request a review every 3 months. Primary care prescribers: Antipsychotic prescriptions require a prescribing care plan. Try withdrawing/stopping the drug after 3 months GP referral to a memory clinic. Dementia can't be cured, but it can be treated, particularly in its early stages, so a prompt diagnosis is important in order to limit the progression of the disease. giving you plenty of time to research and plan for the later stages of the disease. That might involve care in a nursing home or a live-in. GP survey reveals why dementia diagnosis rates are so low. Two thirds of GPs say many people with dementia are not being diagnosed because they are not making an appointment to see their doctor, an Alzheimer's Society survey has revealed. The survey of 382 GPs provides new insight into why diagnosis rates for dementia continue to be so low Diagnosed with Alzheimer's Disease ten years ago, the former GP has the reassurance of good care in a 'dementia inclusive' retirement village, a drug regimen that is working well for her and the.

Advance care planning is a key way to improve the quality of care delivered to people with dementia. It has been associated with significant reductions in rates of hospitalisation and increased use of hospice services among people with dementia. It can also reduce stress, anxiety and depression in relatives 4. Managing your own care plan 5. Whose care plan is it anyway? 6. What's in a care plan? 7. Safety planning 8. Involving carers and families 9. Writing good care plans 10. Involvement 11. Accessibility and communication 12. Choice and capacity 13. Professional approach to care planning 14. Coordination of care plans 15. Types of care plan 16 Methods: DelpHi-MV is a GP-based cluster randomized controlled intervention trial. DelpHi-Intervention aims to provide optimum care by integrating multi-professional and multimodal strategies to individualize and optimize treatment of dementia within the framework of the established healthcare and social service system

The Care Services Improvement Partnership (CSIP) has produced best practice guidance for primary care staff related to the mental health domains. This has been serialised in Guidelines in Practice, and concludes this month with the dementia clinical domain. The mental health domain was featured in the November 2006 issue of the journal, and the. Background Due to the disease's progressive nature, advance care planning (ACP) is recommended for people with early stage dementia. General practitioners (GPs) should initiate ACP because of their longstanding relationships with their patients and their early involvement with the disease, however ACP is seldom applied. Aim To determine the barriers and facilitators faced by GPs related to. Primary care networks; GP Wellbeing; GPs to receive more training to spot dementia. GPs will receive more training and support in diagnosing people with dementia, in plans announced as part of the government's five-year strategy on the condition. by Siobhan Chan. Care home: GPs to receive dementia training A general practitioner (GP) or family doctor provides primary care for a wide range of medical conditions for all age groups. The GP has a central role in coordinating care and in understanding the family and social background. The GP may refer to a specialist for diagnosis and ongoing management of dementia. The GP will continue t

Dementia Action Alliance in the UK provide links to case studies of general practices' action plans to become more dementia friendly. Link. confidence and capacity within general practice. Each section of the guidelines encourages the nurse to think about current practice and the evidence to support each recommendation. The four steps. support. General practice plays a very important part in dementia patients' life this is because the GP practice is the one who opens up the door to information. They are the one who provide the right support and plan to the patient. GP's are the one who hold a responsibility for care plans and reviews for ongoing management. It is difficult for the dementia patients to remember everything A clear plan Experienced RN Caroline Gibson was working as a dementia support nurse with district nursing when she realised people with dementia weren't getting what they needed from primary care. Victorian government data about current and predicted prevalence of dementia in the region helped justify the need for the clinic

What is a Care Plan? Who Are They - UK Dementia Director

He lives in a 'dementia specialist' residential home and needs regular assistance with his personal care. His general practitioner (GP) referred him to the local community mental health team for older adults because of his resistance to personal care - he had hit two care workers with a baton when they tried to help him Background Global policy recommendations suggest a task-shifted model of post-diagnostic dementia care, moving towards primary and community-based care. It is unclear how this may best be delivered. Aim To assess the effectiveness and cost-effectiveness of primary care-based models of post-diagnostic dementia care. Design and setting A systematic review of trials and economic evaluations of. Background End-of-life-care is often poor in individuals with dementia. Advanced care planning (ACP) has the potential to improve end-of-life care in dementia. Commonly ACP is completed in the last six months of life but in dementia there may be problems with this as decision-making capacity and ability to communicate necessarily decrease as the disease progresses Item 2712 is for an attendance by a GP to review a GP Mental Health Treatment Plan or to review a psychiatrist assessment and management plan. Recommended frequency is an initial review between four weeks and six months after the completion of the GP Mental Health Treatment Plan and, if required, a further review at least three months after the. On entering residential care, 44% of 2250 new residents with dementia saw a new GP and 29% saw a GP that was known to them but who wasn't their regular GP. The rest saw their usual GP. The researchers found those who saw a different GP when they entered residential care were more likely to be prescribed antipsychotics or benzodiazepines

dementia - and helping those living with the condition - has been a personal priority of mine. The fall-out on people's lives can be simply catastrophic. Those coping with dementia face the fear of an uncertain future; while those caring can see their loved ones slipping away. Dementia also takes a huge toll on our health and care services The plan limits red meat, butter and stick margarine, cheese, sweets, and fried foods. Keep in mind that eating isn't just about nutrients and calories. It's also social and personal, and a.

During the duration of the project, over 200 GP surgeries in Wessex were contacted and by the end of July 2017, over 150 surgeries had completed the steps to become dementia friendly. A further 25 surgeries have undertaken many of the actions necessary to become dementia friendly. This project has now been mainstreamed into the primary care. NHS England said it was not just payment for diagnosis and GP practices would have to form a detailed plan and show improving diagnosis rates. linked to delivering care for dementia patients A visit to a GP is an opportunity for the care home staff to proactively address the health needs of the residents. When health issues are communicated to the GP promptly and in the right way, better health outcomes can be achieved. For this, you, as a care home staff, have to make the most of the GP visit The evidence underpinning this initiative was the RCN Dementia survey of 2,184 professionals, patients and carers in 2011, from which the SPACE principle was developed for use in hospital care. Dr Decker adapted this for primary care and named it iSPACE, with the purpose of improving patient and carer experience, teamwork and clinical.

Advanced care plans in dementia - Medical Protectio

The Northern Sydney Dementia Collaborative was established in 2014, with assistance from the NSW Agency for Clinical Innovation's Building Partnerships program, which aimed to form alliances that work together to integrate care for older people with complex health needs The Regional Dementia Care Pathway sets out our vision for high quality dementia services in Northern Ireland. This Care Pathway describes the care that a person with dementia may receive from the moment they consult their GP with concerns about symptoms such as short-term memory loss, and are diagnosed with dementia, through to the end of. Anticipatory Care Planning: Frequently Asked Questions. Purpose. The purpose of this guidance is to provide practical support to local teams. Anticipatory and Advance care planning ( ACP), in practical terms, are both about adopting a thinking ahead philosophy of care that allows practitioners and their teams to work with people and those close to them to set and achieve common goals that. Dementia. Dementia is the term used when a person experiences a gradual loss of brain function due to physical changes in the structure of their brain. Dementia is not a normal part of the ageing process. However, it is more common for people over the age of 65, but can affect people as young as 45 Your care plan is personalised to you, and what is in it will depend on your needs. The support could include: adaptations or equipment to make your home safer and easier to live in. help from home carers or a personal assistant. a personal alarm to call for help. help to regain your independence and confidence after an illness or injury.

Dementia - Royal College of General Practitioner

Guidance for GP practices on Anticipatory Care Planning Conversations with People with Dementia living in the Community during COVID-19 1. This letter requests that GPs follow the attached guidance for patients living with dementia, their families and carers. 2. The attached is in addition to the current guidanc Dementia diagnosis rates increased (15.9% for people aged over 65), care planning increased by 26% for face to face reviews and 80% of surgeries now have a dementia noticeboard. Full detail at The AHSN Network. iSPACE (captioned): Making GP Surgeries Dementia Friendly from Wessex AHSN Limited on Vimeo. iSPACE (captioned): Making GP Surgeries. From the diagram: Dementia Care Pathway Slides , we can see that from diagnosis to a trigger event, nothing much happens in General Practice other than the annual dementia review, which tends to be a rather vague event leading to a reactive rather than proactive service. The white space is filled by the voluntary agencies and these vary across. A personalised care plan to manage behavioural disturbances is important for people with dementia. Often, a person-centred approach can help diffuse such behavioural disturbances. Alternatives to drugs should be tried before prescribing medication. Specialist advice should be sought if medication is being considered

The primary care dementia support team in Swansea provides a first point of contact for anyone concerned about changes in their cognitive health, i.e their thinking skills and memory. If you are concerned, you can contact the team direct via the common access point on 01792 636519. You can also see your GP, who may refer you to the team • Dementia training was a need highlighted, for staff in a healthcare setting such as hospitals, care homes, GP practices and pharmacies. • View that all nurses/care home staff should have training in dementia and this should be compulsory during induction. • Greater consistency in nursing care is required - in a hospital and care homes Objective To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners. Design Multicentre randomised controlled trial. Setting Nine memory clinics and 159 general practitioners in the Netherlands. Participants 175 patients with a new diagnosis of mild to moderate dementia living in the community and their.