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Dementia
About this booklet
This booklet summarises the recommendations NICE and SCIE have made to the NHS and social
care services in `Dementia: supporting people with dementia and their carers in health and social
care' (NICE clinical guideline 42).
Who should read this booklet?
The booklet is for health and social care staff who work with people with dementia and their carers,
and those who work with older people and people with learning disabilities.…read more

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Dementia Contents
Contents
About this booklet 2
Key priorities for implementation 4
Principles of care 6
Diagnosis and assessment 9
Promoting independence and maintaining function 13
Interventions for cognitive symptoms and maintenance
of function 14
Interventions for non-cognitive symptoms and behaviour
that challenges 16
Interventions for comorbid emotional disorders 19
Palliative and end-of-life care 20
Support for carers 21
Integrated and coordinated care 22
Accommodation and hospital care 23
Staff training 24
Implementation 26
Further information 26
This guideline makes specific recommendations on Alzheimer's disease,…read more

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Dementia Key priorities for implementation
Key priorities for implementation
The following recommendations have been identified as priorities for implementation.
Non-discrimination
G People with dementia should not be excluded from any services because of their diagnosis, age
(whether designated too young or too old) or coexisting learning disabilities.
Valid consent
G Health and social care professionals should always seek valid consent from people with dementia.…read more

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Dementia Key priorities for implementation
Key priorities for implementation continued
Structural imaging for diagnosis
G Structural imaging should be used in the assessment of people with suspected dementia to
exclude other cerebral pathologies and to help establish the subtype diagnosis. Magnetic
resonance imaging (MRI) is the preferred modality to assist with early diagnosis and detect
subcortical vascular changes, although computed tomography (CT) scanning could be used.
Specialist advice should be taken when interpreting scans in people with learning disabilities.…read more

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Dementia Principles of care
Principles of care
Person-centred care
Treatment and care should take into account each person's individual needs and preferences. Good
communication is essential, supported by evidence-based information, to allow people to reach
informed decisions about their care.
People with dementia should have the opportunity to make informed decisions about their care and
treatment in partnership with their health and social care professionals.…read more

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Dementia Principles of care
Diversity and equality
G Always treat people with dementia and their carers with respect.
G Ensure people with dementia are not excluded from services because of their diagnosis, age
(whether regarded as too old or too young), or any learning disability.
G If there is a language barrier, offer:
­ written information in the preferred language and/or an accessible format
­ independent interpreters
­ psychological interventions in the preferred language.…read more

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Dementia Principles of care
Ethics and consent
G Always seek valid consent from people with dementia.
­ Explain options and check that the person understands, has not been coerced and
continues to consent over time.
­ Use the Mental Capacity Act 2005 if the person lacks capacity.
G Encourage the use of advocacy services and voluntary support. These services should be available
to people with dementia and carers separately if required.
G Allow people with dementia to convey information in confidence.…read more

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Dementia Diagnosis and assessment
Diagnosis and assessment
Except where indicated, recommendations in this section are mainly relevant to healthcare professionals.
Risk factors and prevention
Risk factors
G Do not conduct general population screening.
G In middle-aged and older people, review and treat vascular and other risk factors for dementia,
such as smoking, excessive alcohol use, obesity, diabetes, hypertension and raised cholesterol levels.
Genetic counselling
G Offer referral to genetic counselling to those thought to have a genetic cause of dementia1 and to
their unaffected relatives.…read more

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Dementia Diagnosis and assessment
Diagnosis and assessment
G Make a diagnosis of dementia only after a comprehensive assessment, including:
­ history taking ­ review of medication to identify any drugs
­ cognitive and mental state examination that may impair cognitive functioning.
­ physical examination
G Ask people who are assessed for possible dementia whether they wish to know the diagnosis and
with whom it should be shared.
G If dementia is mild or questionable, conduct formal neuropsychological testing.…read more

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