Dementia care on medical and medicine for the elderly wards.

Dementia is associated with increased health care resource utilisation and greater co-morbidity burden. Due to the psychophysiological and social demands of dementia, specific approaches to care, communication, environment and clinical treatment are needed. Timely diagnosis can greatly improve quality of life. Dementia is often not coded in hospitals as it is not considered the primary reason for admission. These missed opportunities have potential to serve as important checkpoints for proper diagnostic assessment. Upon discharge, adjustments can be made to manage these patients better. In April 2012, the dementia CQUIN was introduced with goals for early diagnosis of dementia at point of hospital admission. This study aims to investigate if the raised profile of dementia care has been generalised across the whole system, the impact on management and whether there is a difference in dementia care between geriatric and medical wards. There was excellent performance across the board for review of medication, prescription of anti-psychotics, ordering of routine bloods and neurological examinations. Increased awareness is needed for dementia-specific blood tests, namely: thyroid function test, B12 and folate. Geriatric wards performed consistently better than medical wards for all aspects of clinical care examined. For medical wards, incorporating multi-disciplinary care would be useful in managing these patients more holistically.