A guide to your memory assessmentWhy you might be asked to have a memory assessment and what it will involve.

August 2014

Cognitive impairment and dementia services

2 A guide to your memory assessment

A guide to your memory assessmentYou have been referred by your GP because you or somebody close to you has noticed that your memory or other thinking skills are not as good as they have been in the past. Some people may also notice a change in personality and behaviour

This leaflet aims to provide you with some information about the process of having your memory and thinking skills assessed.

Many people can describe a variety of problems such as getting confused about simple things, losing items in the house, getting lost or forgetting recent conversations. The aim of our service is to explore what might be causing the difficulties with your memory or other thinking skills, and how we might be able to help.

Memory and other thinking skills are often called ‘cognition’ and we will use this term in the rest of this leaflet.

What will the assessment involve?Your first meeting will be with one of our team: a nurse, occupational therapist, doctor or psychologist. With your permission, we will also try to speak to a member of your family or somebody else who knows you well.

The aim of this first meeting is to gather information so we can understand what might be causing the problems you, or those around you, might have noticed. As part of this you will be asked about your personal history and your current difficulties.

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You will also be asked to complete a brief test of your memory and thinking skills. This appointment will usually take 11/2 to 2 hours.

There is no single test we can use to determine what might be causing a problem with somebody’s cognition or behaviour, so we may ask you to go for further investigations.

These can include blood tests and a brain scan, such as an MRI or CT scan, as well as an ECG to understand how your heart is functioning. You may also be asked to meet with a clinical psychologist, who will complete a more in-depth ‘pen and paper’ examination of your thinking skills with you.

After any other investigations have been completed, you will then be invited to meet with a doctor, who will explain what may be causing your difficulties, and offer treatment and support if appropriate.

The length of the whole assessment can vary between different people depending on the extent of the investigations we require to identify a possible diagnosis and begin the correct intervention.

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Reasons for cognitive problemsThere are four main causes of cognitive and behavioural problems:

1. Normal ageing - everybody’s memory and thinking skills get a little worse over time. We aim to compare your functioning to other people of your age to identify whether your difficulties are as we would expect.

2. Physical health conditions - a number of physical health difficulties and the treatments received for these can cause memory problems. These include epilepsy, infections, Parkinson’s disease, and the medications taken to manage many conditions.

3. Difficulties with your mood/stress - when we feel low or under pressure because of challenging life events, this can have a significant impact on our memory and concentration skills, making it harder to capture and process information. If these are difficulties for you, we can explore what might be helpful to manage this.

4. Dementia - this term is used to describe a range of conditions which affect an individual’s thinking skills as a result of a disease or injury to the brain. The most common types of dementia are Alzheimer’s disease and vascular dementia, although there are other more rare dementias.

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It can be difficult to identify what might be causing memory or other cognitive problems. When somebody has subtle difficulties with their memory or multiple health issues, it can be even more challenging to achieve the correct diagnosis.

In this case we would monitor you and invite you back for assessment in the future.

What are the benefits of continuing with an assessment of my cognition?An assessment can be helpful to:

• Exclude any treatable conditions which may have symptoms which impact on your thinking skills, such as mood difficulties or physical health problems.

• Exclude other causes of confusion, such as visual or hearing problems, the side effects of drugs, or the impact of recent life events.

• Access advice, information or support from social services, charitable and specialist support groups.

• Enable people to have an explanation for their difficulties and plan for the future.

There may be specific medication that can help in slowing the progression of certain types of dementia.

Some people can feel anxious about an assessment and decide they do not want to know what is causing their difficulties.

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Do I have to continue with the assessment if I don’t want to?This assessment is entirely voluntary and you do not have to go through with it if you do not want to. If you feel under pressure please let us know and we can stop.. The clinician working with you will ask for your consent to continue and if you would like to know the outcome of an assessment.

What if I have more questions?We understand that deciding to pursue an assessment can feel daunting. People are naturally anxious to obtain an understanding of their problems as soon as possible and we are here to answer any questions you may have along the way.

Your first meeting with one of our team is a good opportunity to ask further questions about the assessment. It might be helpful to write down beforehand any concerns or queries you may have.

What if English is not my first language?Please let us know if English is not your first language and if you think a translator would be helpful to explain your difficulties.

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020 8354 8354Email

communications@wlmht.nhs.uk@

24 hour support line

0300 1234 24424/7

Where will my assessment take place?Your memory assessment will generally take place in the borough where you live. This will be written on your appointment letter.

London Borough of Ealing - EastSycamore Lodge1 Edgecote Close, Acton, W3 8PH

Tel: 020 8483 1666

London Borough of Ealing - WestElm Lodge4A Marley Close, Greenford, UB6 9UG

Tel: 020 8483 2646

London Borough of Hammersmith & FulhamSt Vincent’s49 Queen Caroline St, Hammersmith, W6 9QH

Tel: 020 8483 2525

London Borough of HounslowLakeside Mental Health UnitTwickenham Road, Isleworth, TW7 6AF

Tel: 020 8483 1800