Memory assessment service (MAS) - referral guidance
MAS is a short-term service for people who have suspected progressive dementia with chronic cognitive decline > 6 months, low risk, not in crisis and who consent to referral.
- Diagnostic assessment
- Post-diagnostic support for people diagnosed with Dementia elsewhere e.g. in primary care or in hospital
Please specify whether referral is for diagnosis & support or post-diagnostic support only.
If in crisis/urgent/high risk your referral will be sign-posted to the Complex care and Dementia team. Sometimes we may contact you to offer advise or to gain further information.
GPs can diagnose moderate-severe dementia see local Primary care guidance on Dementia Roadmap – Healthcare professionals Section
For advice please contact your local consultant. Please see consultant secretary contacts and email addresses for referrals below.
After completion of our input the patient will be referred on for longer term support (e.g. PCDP service or memory nurse in East)
Acute confusion < 4 weeks - please consider causes of delirium
Rapidly progressive cognitive decline consider alternative causes e.g. delirium, brain tumours, brain haemorrhages, medication
Under 55 when dementia is extremely rare, discuss with consultant prior to referral orconsider referral to neurology.
Consider risk to self/others
Please include in your referral:
- Whether patient is being referred for a diagnosis or has a diagnosis and is being referred for post-diagnostic support only
- Confirm patient consents to referral(if patient lacks capacity considerbest interests decision and GP diagnosis and offer referral for support to patient/carer, we are happy to discuss these cases prior to referral)
- Whether patient is happy to have a telephone/video appointment or wants face to face (wait for face to face appointments is longer especially during COVID19 Pandemic)
- Contact details for NOK/carer (where possible)
- Brief history confirming chronic cognitive decline> 6 months and confirm it is affecting ADL’s.Use IQCODE questionnaire
Could be completed by a family member or a carer.
- Relevant physical examination and previous investigations(e.g. CT or MRI head, neuro assessments, signs Parkinsonism, ECG)
- Brief cognitive test result e.g.6CIT
can be completed via phone if face to face not appropriate, mini ACE
- Dementia screening bloods reviewed and stable. Please attach results.
(FBC/U & E/Bone/LFT/TFT/B12/Folate/HbA1C-from last 6 months.Up to the last 6 months is acceptable provided results were within the normal range and patient’s physical health has been stable. If recent delirium or previously raised CRP – please test prior to referral. Explain/correct abnormalities prior to referral where possible.
- Depressionand anxiety considered and treated
- Please attach patient profile
Patients who may not be appropriate for MAS diagnosis
No consent – if patient appears to lack capacity consider whether GP diagnosis can be made in their best interests and refer for support (if risks will may need CC&D team)
Permanent resident in care home and all their needs are met– can be diagnosed by GP with DiaDEM tool http://www.yhscn.nhs.uk/mental-health-clinic/Dementia/Diagnosis.php#DIADEM and referred for support
Patients under specialist Learning Disability Service – discuss with LD team
Cognitive impairment due to acquired non- progressive/fixed brain damage – refer neurology (e.g. single trauma brain injury)
Current alcohol or drug dependency (need 3/12 abstinence needed prior to referral, treat with thiamine prior to referral)
Recently discharged from hospital, may still have delirium – reassess prior to referral allow time for delirium to settle (at least 2 weeks)
Recent stroke – if new cognitive impairment allow at least 6 months prior to referral as there may still be improvement.