Cognitive Impairment and Dementia
Adult

Cognitive Disorders Service

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Emergency Referrals

Useful Management Information

The service supports the diagnosis and initiation of management of Cognitive Impairment and Dementia for adults over 45 years, where there has been progressive decline in cognition, memory or language, and where this is unlikely to be related to drug or alcohol use, Axis 1 psychiatric disorders or personality disorders.
Referral to accredited pharmacist for Home Medical Review/Residential Medication Management review if evidence of polypharmacy
If malnourished, consider referral to a dietitian
Referral to occupational therapy driving assessment if locally available
Consider ongoing Allied Health support as appropriate i.e. Dietitian, Social Worker, Occupational Therapist, Physiotherapist, Psychologist, Speech and Language Therapist
Telehealth appointments for initial assessment are generally not appropriate for this cohort of patients; however, telehealth review appointments can be negotiated under special circumstances.

Clinician resources

Patient resources

Diagnosis, treatment and care for people with dementia – A Consumer Companion Guide
Caring for someone with dementia
My Aged Care
Occupational Therapy Australia
Find an OT
Elder Abuse Prevention Unit
Younger Onset Dementia & NDIS

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	Presence of concerning features  (may include but not limited to): Behavioural and Psychological Symptoms of Dementia (BPSD) – moderate to severe stage include rapidly evolving (over weeks) Unresolved safety concerns in current living situation (patient or care giver) Suspected elder abuse or self-neglect: physical, psychological, or financial) Rapidly evolving (over weeks) Significant caregiver stress (patient's care provision at risk)
Category 2 (appointment within 90 calendar days)	Patients with a suspected dementia who do not meet category 1 criteria
Category 3 (appointment within 365 calendar days)	No category 3 criteria
If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Current list of medications
Relevant medical, psycho-social history (psychological symptoms), co-morbidities, allergies, and assessment of medication adherence
Brief history regarding the cognitive, behavioural and functional changes/decline and their timeline
Safety concerns e.g. unsafe walking and driving, medication non-compliance, unintentional weight loss, living alone, compromised insight (if relevant) disorientation in public spaces; concerns re. financial mismanagement and/or abuse
Assessment of cognitive function with validated document
Investigation blood test results - FBC, ELFT, Calcium, TSH, Vitamin B12 (if available)
Recent brain imaging reports (CT or MRI Brain) (if available)
Care-giver or other informant contact details (if patient consenting)
Social situation: living alone; partner/family supports?

If a specific test result cannot be obtained due to access, financial, religious, cultural or consent reasons a clinical override may be requested. This reason must be clearly articulated in the body of the referral.

Additional Referral Information

Risk factors for cognitive impairment including strong family history, diabetes, smoking and sleep study (if completed)
Rockwood Clinical Frailty Scale score (if available)
Is there currently any of the following in place, if so please attach or provide information:
- GP Management Plan (GPMP)
- Team Care Arrangement (TCA)
- Mental Health Management Plan (MHMP)
- Recent Health Assessment (HA)
Enduring Power of Attorney & Advance Health Directive & Statement of Choices document (copy)
Availability of transport to appointment and willingness to attend appointment or is home visit required?
- This may vary dependant on your local region service.
Willingness or suitability to participate in Telehealth/virtual clinic

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

Secure Web Transfer

Send to: Gold Coast Adult Community Health QHealth

Internal Referrals

Not Accepted

Fax

07 5687 4497

Post

Central Intake Unit
Robina Health Precinct
Level 4, 2 Campus Crescent
Robina QLD 4226

Enquiries

07 5635 6262

Related HealthPathways

No directly related pathways found

HealthPathways home page

Service Availability

Dr Ganesamoorthy Subakumar

Facilities

Robina Health Precinct

Tugun Satellite Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Cognitive Impairment and DementiaAdult