1. The Neuropsychiatric Inventory - questionnaire (NPI-Q), provides a reliable assessment of behaviours which are often seen in patients suffering from dementia (Cummings et al 1994).The assessment is carried out when the family/carer attends the memory clinic with the patient. On completion of the NPI-Q the consultant is able to assess the frequency and severity of the symptoms in the patient, as well as the distress these symptoms cause to the carer. There are 10 domains of the NPI-Q, which are based on responses from an informal carer. When each domain is completed the carer is then asked to complete the carer distress questionnaire. NPI-Q IS NOT JUST A PAPER EXERCISE.. MEMORY CLINIC SERVICES Psychogeriatrician Psychologist Registered Mental Health Nurse Occupational Therapist Healthcare Support Worker Collaborative Working Resources Statutory/voluntary Services HCSW Roles & Responsibilities. Accountability, Professionalism, Patient Advocacy. Capability, Training, Education, Knowledge. Record Keeping and Standards. Clinical procedures. Education - Patients/Carer’s/Juniors. Supervision, Feedback, Communication. Interventions, Signposting Person Centred Care Assessment. Early diagnosis Promoting Autonomy, Choice & Empowerment Holistic Care. Intervention Education. Therapies. Resources Wellbeing The Role and Responsibilities of the Healthcare Support Worker (HCSW) Within the Memory Clinic The Role and Responsibilities of the Healthcare Support Worker (HCSW) Within the Memory Clinic The role of the healthcare support worker within the memory clinic is completing the NPI-Q with the patient’s family/carer. Many skills are required when carrying out this assessment, so it is vital that HCSW’s receive the appropriate training to promote confidence and competency to carry out the assessment. Families/carer’s can often become distressed during the assessment, when a situation like this arises, it is important as a HCSW to recognise your abilities in managing the situation and that you may need to inform a qualified member of the team to assist (WAG 2010). To ensure the delivery of safe care to the service user and their family/carer, it is essential that HCSW’s are regularly supervised and supported by a qualified nurse. The NPI-Q helps provide the necessary Information that ensures the service user receives the appropriate treatment, care and service that best meet his/her needs. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Available: http://www.ncbi.nlm.nih.gov/pubmed/7991117. Last accessed 10th May 2011. Aberrant Motor Activity Anxiety Apathy Agitation/Aggression Delusions Disinhibition Dysphoria Euphoria Hallucinations Irritability IT PROVIDES INSIGHT INTO HOW THE PATIENT IS FEELING AND BEHAVING Welsh Assembly Government. (2011). Code of Conduct for Healthcare Support Workers. Available: http:// www.wales.nhs.uk/sitesplus/documents. Last accessed 10thMay 2011. Welsh Assembly Government. (2010). Setting the Direction. Primary and Community Services Strategic Delivery Programme. Available: http://cymru.gov.uk. Last accessed 5th May 2011. People with dementia who develop certain behaviours should be offered an assessment at an early opportunity to establish the likely factors that may cause, aggravate or improve such behaviour ( NICE 2006). National Institute for Clinical Excellence. (2006). DEMENTIA: Supporting people with dementia and their carers in health and social care. Available: http ://www.scie.org.uk/publications/misc/dementia/dementia-guideline.pdf. Last accessed 1st May 2011. Early identification and intervention. Specialist assessment. Access to drug therapies. Effective targeting, monitoring, (cessation where appropriate) of anti-dementia drugs. Education and support for patients and carers. Anxiety management. Advice on memory aids and memory training. The purpose of the memory clinic is to provide : Providing person-centred care can often reduce symptoms such as Agitation, which are often seen in people with dementia. These symptoms can be an indication of having an unmet need which may be causing them distress, this is why it is important to explore the person, not just the symptom. (Dewing 2010). Dewing, J. (2010). Responding to agitation in people with dementia.. Nursing older people. 22 (6), p18-25. CARING FOR THE CARER Carers assessment. Advice and information about dementia. Support groups. Help lines Emergency contact details Respite and day care services. Caring for someone with dementia can present many problems that can differ from those faced by other carers, (NHS 2010). The behaviours seen in people with dementia are often what causes families/carers the most distress. Families/carers have said that when completing the NPI-Q it helps them understand the reasons why their relative behaves in a certain way, which helps them manage the behaviours and continue caring. National Health Service. (2010). Caring for someone with dementia. Available: http://www.nhs.uk/CarersDirect/guide/kinds/Pages/dementia. Last accessed 19th April 2011.