Patient arrives in A&E / AMU / ED / MAU with evidence of disorientation / confusion

1. First point of presentation for patients with possible Dementia Patient presents to GP with worries about their memory, or evidence or disorientation / confusion Patient arrives in A&E / AMU / ED / MAU with evidence of disorientation / confusion Patient seen by Community Service with possible memory problems / disorientation/confusion/mood change Patient seen in which setting? Acute or Community GP practice Assessment outcome? Probable dementia Toxic confusional state / delirium Investigate & treat physical cause • Refer to CMHT/Dementia Practitioner • Signpost patient to 3rdsector information sources Admission required?(including considerations of patient safety and availability of appropriate care) No Yes • Letter to GP re. referral to CMHT / dementia practitioner • Signpost patient to 3rd sectorinformation sources Direct to appropriate Ward/MFE/MH bed depending on severity of mental health need • Psychiatric/formal cognitive assessment carried out by mental health specialist practitioner / mental health liaison nurse • Ongoing medical and other assessments/reviews • Involvement of therapy team, social worker, and family members from day one • Utilise Pabulum blue book or “this is me” Ongoing discharge planning • patient MH bed OR • existing dementia diagnosis? Yes MH Liaison referral to CMHT/dementia practitioner • Letter to GP re. referral to CMHT / dementia practitioner • Signpost patient to 3rd sectorinformation sources Discharge to own home, care home or new care setting as appropriate.