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Dr. Peter O’Brien talks Mini Cog Diagnostic Tool for Dementia

Tags

  • Clock drawing for dementia diagnosis
  • Coventry
  • Dementia
  • Dementia Diagnosis
  • Doctors
  • GPs
  • Health
  • Practitioners
  • Research
  • Social Care
  • Warwickshire

At Forrest Medical Centre in Coventry, we have been keen over many years to improve our rate of detection of patients suffering from dementia. To do this we ideally need a test that can be used with a consultation and preferably one that can be used by different members of the primary health care team.

Originally we had the “Mini Mental state” test, but this takes such a long time to administer that it did not fit in well with the pattern of work in a general practice – so, in the 1990s, when we when we learnt of the 6 item Cognitive Impairment Test (6CIT), we changed to using this as it was much quicker and simpler to use.

A few years later, we came to hear of the Mini-Cog test, and saw the evidence that it was 99% sensitive at picking up cases of dementia, with only 7% false positives. We decided to change to using this, and found that we made much more use of it during consultations than we had with the 6CIT.

Details of how to do the Mini Cog Assessment are below:

The Mini Cog is a quick, sensitive screening test for dementia, which can be administered by either trained or untrained staff

It consists of 2 parts: a 3 item recall test and a clock-drawing test.

At the start of the test, tell the patient that you are going to give them 3 words, which you will ask them to repeat straight away and then again after 1 minute (during which time you will have done something else, or had some other conversation to distract the patient).

The 3 words normally used are: APPLE, PENNY, TABLE (an alternative would be  car ball man)

The number of words correctly recalled is given as a score: 0, 1, 2 or 3.

The patient is then asked to draw a large circle and fill in numbers as on a clock face, then add hands to the clock indicating a time of 8.20.

The drawing is scored as “normal” or “abnormal”
The patient can be judged to be demented* if:

  • the 3 item recall score is 0; or
  • the 3 item recall score is 1 or 2 and the clock drawing test abnormal.

Using the Mini Cog, the rate at which we accurately diagnosed new cases of dementia rose more than 50% from its previous baseline and has remained higher. The trials of the Mini Cog showed that it could be reliably used by staff who did not have medical training, so we have been happy to encourage other members of our team to use it.

We would encourage other GPs and their teams to make use of this test and would be interested to hear from other practitioners who have seen diagnosis rates improve as a result of using the Mini Cog.

Dr Peter O’Brien is the GP Dementia Champion for Coventry and works out of Forrest Medical Centre in Coventry.

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Coventry and Warwickshire Dementia Portal: Information on supporting a person with Dementia

Tags

  • Alzheimers
  • Carers
  • Carers Support Service
  • Coventry
  • Dementia
  • Dementia Portal
  • Warwickshire

We are getting our information into a final state of readiness to go onto the portal and thought we’d show you some of the content we have got so far. Here are a couple sections taken from the section aimed at people in Coventry and Warwickshire who are supporting someone who has had a dementia diagnosis:

Don’t forget to look after yourself

Sometimes it is possible to become so engrossed in your supporting role that you forgot to think about yourself. Here are some tips to think about to maintain your own wellbeing:

Time to yourself – Make sure you have some regular time to relax or do something just for you. Put aside some time, each day, for yourself – you could have a cup of tea and read the paper, listen to some music, do the crossword or go for a short walk. Remember, there are plenty of options to help you meet your own needs without compromising the needs of the person you’re caring for.

Your health – Caring can be hard work, and you need to be healthy and happy if you are to manage it. Try to eat a well-balanced diet, with at least five portions of fruit and vegetables a day. This will make you feel better and give you more strength and energy. Taking regular exercise is vital for your health and will give you more energy. Walk in the fresh air each day if you can, or do some exercises at home. Ask your GP for advice.

Annual Health Checks – Carers of someone with dementia should have an annual health check once a year to assess both physical and mental capacity to continue in the role.

Your financial well-being – Your legal and financial situation may be affected if you are caring for a person with dementia. There are a number of areas to think about before you make changes to your circumstances.

How can you best support someone with dementia?

There are a number of things that you can do to help someone who has had a dementia diagnosis. Below are some things to think about:

  • Try to put yourself in the person’s situation and understand what they might be trying to say or what they are feeling and relate to that.
  • If memory loss is a problem, give tactful prompts about what time of day it is, what day it is, what you are going to do next.
  • A regular routine might help a person feel more secure and make it easier for them to remember what usually happens during the day.
  • Try not to contradict the person or get into an argument – you’ll both end up exhausted! Try to ‘go with the flow’ and acknowledge what the person has said, even if you know it’s incorrect.
  • Involve the person with daily activities and events, to keep their skills alive and be part of what is going on around them.
  • Break down tasks into sections that can be achieved step by step. For instance, lay out clothes in the order that they will be put on.
  • You might both find it enjoyable to share some happy memories from the past. Photographs and souvenirs may help jog a memory. A person who has short term memory loss may be able to remember things from a long time ago quite clearly.
  • Using questions that start with ‘What / Where / How / Who / When’ may be quite challenging to a person who has difficulty remembering so it might be worth trying to avoid those.

Please tell us what you think. Have you got some tips as someone who supports a person with dementia? Let us know. You can  post your suggestions in the comments section under this post or send us an email.

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Welcome to the Coventry and Warwickshire Living Well with Dementia Partnership

Tags

  • Alzheimers
  • Bedworth
  • Coventry
  • Dementia
  • Health
  • Leamington
  • Nuneaton
  • Partnership
  • Rugby
  • Social Care
  • Stratford
  • Warwick
  • Warwickshire

The Coventry and Warwickshire Living Well with Dementia Partnership is a partnership made-up of Local Authorities, NHS, Private and Voluntary Sector organisations dedicated to:

  • raising awareness of dementia;
  • improving post diagnosis support for everyone with a dementia diagnosis and their carers; and
  • improving the quality and access that social care and health practitioners have to local, service-related information about dementia.

The Coventry and Warwickshire Living Well with Dementia Partnership currently consists of representatives from:

We are always looking for new partners and there are a number of ways you can get involved.

About this Blog

This blog is managed by Katherine Herbert and Paul Coxon, from Warwickshire County Council, and will be used to run news stories and raise awareness of events around dementia from across the Partnership. Expect posts covering a wide range of audiences from people with dementia and their carers to practitioners working in Social Care and Health.

Got a story that you would like to tell or a topic that you would like us to cover? Then Get in touch.

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