Out of Hours Psychiatric assessment of patients with dementia in the community Physical decline and behavioural ADDRESS FOR CORRESPONDENCE disturbance in advancing dementia often Ketan Dipak Jethwa precipitates hospital or nursing home “Numerous rating Nottingham University Hospitals NHS Trust, 1 admission. The coexistence of behavioural scales are available Nottingham City Hospital, Hucknall Road, or psychological symptoms and physical Nottingham NG5 1PB, UK. illness requires timely input from a number to assess different E-mail:
[email protected] of professionals in both the health and aspects of dementia, social services. Numerous rating scales are available including cognition, to assess different aspects of dementia, psychopathology, quality including cognition, psychopathology, quality-of-life, and caregiver burden. of life, and caregiver burden.” Montreal Cognitive Assessment The Montreal Cognitive Assessment (MOCA)2 is a 30-item instrument that assesses a broad range of cognitive domains, including visuospatial reasoning and executive It is important to note that depressive or function and can be administered within anxiety symptoms can lower scores on 10 minutes. The MOCA is more effective cognitive testing. at differentiating between mild cognitive impairment and early Alzheimer’s disease Screen for Caregiver Burden than the Mini-Mental State Examination The Screen for Caregiver Burden (SCB)5 is a (MMSE).2 In addition, the MMSE does not short self-report questionnaire that can be test for frontal lobe (executive) functions. administered while carers are waiting to be Follow-up assessments can be used to seen. This scale assesses the occurrence track progress. of distress associated with common care experiences and can be used to target Brief Psychiatric Rating Scale social service interventions.