Cognitive Issues

Remember to look beyond dementia and understand that a person living with dementia is still an individual and so are their carers.

If a person cannot communicate, he or she may respond well to sound and touch.

Impaired cognition makes assessment and management of pain more complex. Tools such as the Abbey Pain Scale and reports from family and carers are useful - see Pain in Residential Aged Care Facilities: Management strategies (requires payment but Executive summary is free)

Check the RACGP Silver Book sections on Dementia and Behavioural and psychological symptoms of dementia for practical guidance on care issues. 

Understand what your role can be in advance care planning. Check if there is an advance care plan or directive. Make sure that a substitute decision-maker is identified and clearly noted in care documentation. The substitute decision-maker may not necessarily be the next-of-kin.

End-of-life care in a residential aged care home setting may mean changing usual care practices eg. not showering or getting a person out of bed.

People with moderate to severe levels of cognitive impairment associated with dementia or other conditions, cared for at home, may be eligible for the dementia and cognition supplement.

Tell families they can find high-quality and trustworthy dementia resources and information at healthdirect or Dementia Australia.

Carers may need to know of options for respite care.

The Kimberley Indigenous Cognitive Assessment (KICA-Cog) or KICA-Screen tool is recommended for use with remote living Indigenous Australians as it is considered culturally appropriate.

The Rowland Universal Dementia Assessment Scale (RUDAS) should be considered for assessing cognition in CALD populations.