Call to lift GP dementia training

The federal parliamentary committee inquiry into the early diagnosis and intervention of dementia has tabled its final report making a wide range of recommendations, including the development of a Dementia Link Worker and higher training standards for GPs

By Linda Belardi.

A federal parliamentary committee has called for a national dementia-training program for GPs to be developed to improve the country’s rates of early diagnosis and intervention.

The report, Thinking Ahead, released on Monday, called for the Department of Health and Ageing in collaboration with the Minister’s Dementia Advisory Group and the Royal Australian College of General Practitioners to develop a program targeting GPs’ misconceptions and gaps in knowledge.

The government’s Living Longer Living Better reforms include a commitment of $27 million towards achieving timely diagnosis for dementia, incorporating frontline clinical training.

The Committee heard evidence from a range of consumers, medical practitioners and other health professionals, that there was a need for a greater awareness of dementia within the medical profession, as the first point of call for a person seeking assistance for symptoms of memory loss or cognitive impairment.

Fiona Young, a Clinical Nurse Consultant in Tasmania, said it should not be assumed that health professionals had a good understanding of dementia. “We cannot assume that [GPs] understand what the signs and symptoms of dementia are and how that affects people’s day-to-day lives.”

Jack Sach from Alzheimer’s Australia Victoria told the Committee that many GPs were not well trained in the application of cognitive screening and some were reluctant to refer on to specialists.

He said there was also a limited understanding of the latest evidence that the risk of dementia could be reduced through lifestyle factors and the progression of cognitive decline could be managed.

The Committee was given anecdotal evidence that some GPs were either fearful of providing their patient with a diagnosis, or falsely believed that providing a diagnosis was futile.

Mark Howland, a Clinical Nurse Consultant, said that the lack of understanding of dementia across the medical community caused cases of misdiagnosis.

The RACGP recognised that people with early stages of dementia were not being diagnosed in primary care and said that GPs needed ongoing training and awareness across a range of areas including services, guidelines and therapies.

Professor Dimity Pond informed the Committee of a GP education trial that had been undertaken in specific regions around Australia using evidence-based strategies, which raised the identification rate for dementia from under 50 per cent to 65 per cent amongst GPs.

She said the training would not be hugely expensive and would be aimed at destigmatising dementia for GPs.

Elements of the training program should include challenging stigma and misconceptions, current best practice and implications of the latest research, as well as diagnosis, care and support pathways for people with dementia and their carers, the report said.

Establishing a Dementia Link Worker role:

Among its other proposals, the report also recommended that the DoHA examine the case for establishing a Dementia Link Worker role to assist in the ongoing case management of people with dementia and their carers.

A Dementia Link Worker, with a background in nursing, psychology, occupational therapy or social work, could provide support, advice and advocacy for the person with dementia and their family, and help coordinate a person’s care from the point of diagnosis and throughout treatment and support.

The Committee heard that there is a need to give people with dementia access to a ‘real person’ to help provide information and support, and to link them in with the appropriate services. Dementia Link Workers may also provide information about advanced care planning, carer stress, and access to services such as respite.

NSW Health envisaged that this role would be filled by a person with a nursing or allied health qualification, skilled in dementia care, who worked closely with the person’s GP or Aboriginal Medical Service, proactively following up after diagnosis and building an ongoing relationship. “The key worker would case manage a person’s care needs as they increased or became complex, and would assist the person to remain independent for as long as possible,” NSW Health told the committee.

Alzheimer’s Australia South Australia has already implemented a Dementia Link Worker program where DLWs are positioned within memory clinics and hospitals to access people at the point of diagnosis.

Marie Alford, of Alzheimer’s Australia South Australia, said that the program has been a success, and was especially important for people living alone. She said those people who had access to a DLW were more likely to be supported through their dementia journey than those people who received just written information. 

Alzheimer’s Australia said that the implementation of a Dementia Link Worker program would require the development and endorsement of an accreditation program with appropriate competencies and professional development requirements.

To read the parliamentary committee’s full recommendations, download the report here.

Tags: alzeheimers-australia, dementia, dementia-training, gps, lllb, parliamentary-committee,

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