Step 1: What to expect from the memory assessment process
If you have been referred for a memory assessment it is common to want to know more about the wait times, what the difference between a virtual and in person appointment is, what to expect on the day, and who you will see when you are there.
This section of the website has been created to help you know what to expect, and to prepare for your appointment. You do not need to do anything in particular, and there is variation between memory clinics in terms of wait times, assessments you will do, and who you will see there, so this is a general guide and may not match your exact experience.
If you have any questions it is best to contact your GP or memory clinic to discuss your individual circumstances.
What will I find here?
The memory assessment process
Advice: What will happen in an assessment
Who will I see on the day?
The memory assessment process
Covid-19 has had an impact on both the wait times for a memory assessment and the ways in which you may be seen by your clinician.
Wait times
Memory clinic waiting times are longer than normal due to the impact of the Covid-19 pandemic. See Step 2 and Step 3 about ways to maintain your well-being while you wait for an assessment, and the sources of support available. If you are struggling, or feel like your or your loved one’s condition is worsening or finding things more difficult to manage, contact your GP or memory clinic for advice.
Where will I be seen?
There are a number of options available for how you have your memory assessment. In-person appointments in a clinic are the traditional method for memory assessments, but during the pandemic options to be seen at home, either on the phone, through a video call, or by someone coming to visit you in person, were also added. Some considerations are set out below to help you in making your decision. All the options mentioned below may not be suitable for everyone.
The nurse or doctor you are working with may look at all the information and decide with you which type of assessment is best for you.
Assessment Options (Click to learn more)
Option 1 : Assessment by Telephone
Pros
- No risk of infection (coronavirus)
- No internet needed
- No need to travel to an appointment
Cons
- May be difficult if you are hearing impaired
- May need an extra appointment for physical checks such as blood pressure
- May need a few telephone calls, rather than one appointment
- Depending on your situation it may be difficult to find a quiet and private space to have a consultation.
- You may need an extra appointment for physical checks and any investigations, whilst during a face to face appointment, they may be done there and then.
Option 2 : Assessment by video using a computer, iPad or tablet
Pros
- No risk of infection (coronavirus)
- No need to travel to an appointment
- Extended family members are able to join the appointment using video conferencing
- Support may be available to help you use the technology
- Once set up, video assessments are very straightforward
- Assessment can take place in familiar settings
- Some people with hearing problems find video easier as the person you are speaking to will not need to wear a mask.
Cons:
- May be difficult if you are hearing or sight impaired
- Friend or family may be required to support with some parts of the memory assessment
- Requires a good internet connection and access to a computer, iPad or tablet
- May need an extra appointment for physical checks such as blood pressure
- May require a few phone calls afterwards
- The technology may be a barrier to communication, particularly if not familiar to you
- Depending on your situation it may be difficult to find a quiet and private space to have a consultation.
- You may need an extra appointment for physical checks and any investigations, whilst during a face to face appointment, they may be done there and then.
Option 3 : Assessment face to face in your home
Pros
- Health professional able to complete physical checks such as blood pressure on the day
- No internet needed
- No need to travel to an appointment
- May not require additional support from carer, friend or family member
- Assessment can take place in familiar settings
Cons
- Risk of infection for patient and carer, friend or family (coronavirus)
- Health professional needs to wear a face mask which could be a barrier to communication
Option 4 : Assessment face to face in a clinic
Pros
- Health professional able to complete physical checks such as blood pressure on the day
- No internet needed
- May not require additional support from carer, friend or family member
Cons
- Risk of infection for patient and carer, friend or family (coronavirus)
- Health professional, patient and carer, friend or family member needs to wear a face mask which could be a barrier to communication
- Need to travel to appointment
If you would like some support to help you decide how you would like to receive your memory assessment, contact your memory clinic or GP.
Advice: What will happen in an assessment
During your assessment there are a number of different assessments that your nurse or doctor may use. This depends on your individual situation, so you may not have all of the below.
Blood Tests
Your GP will arrange for blood tests to help see if the symptoms are caused by conditions other than dementia.
In most cases, these blood tests will check:
- liver function
- kidney function
- thyroid function
- haemoglobin A1c (to check for diabetes)
- vitamin B12 and folate levels
If your doctor thinks you may have an infection, they may also ask you to do a urine test or other investigations.
Taking a history
Taking a history – The nurse or doctor will take a detailed medical and family history.
The aim of this is to gather information to understand what might be causing the
problems that you, or those around you, might have noticed. As part of this, you will
be asked about your personal history and your current difficulties. The nurse or
doctor will also want to talk to someone who knows you well to find out what they
may have noticed to help get a clearer picture. This is usually done at the same time
or can be done separately.
Mental ability tests to diagnose dementia
People with symptoms of dementia are given tests to check their mental abilities, such as memory or thinking.
These tests are known as cognitive assessments, and there are several different types. Those commonly used in memory clinics are the Addenbrooke’s Cognitive Examination (ACE), the Montreal Cognitive Assessment (MoCA) and the Mini–Mental State Examination (MMSE).
Although these tests alone cannot diagnose dementia, they may show there are memory difficulties that need further investigation.
Most tests involve a series of pen-and-paper tests and questions, each of which carries a score.
These tests assess a number of different mental abilities, including:
- short- and long-term memory
- concentration and attention span
- language and communication skills
- awareness of time and place (orientation)
Brain scans
Brain scans are often used once blood tests and mental ability tests have ruled out other problems.
Like memory tests, brain scans alone cannot diagnose dementia, but are used as part of the assessment.
Not everyone will need a brain scan, particularly if the tests and assessments show a likely diagnosis.
These scans may also be used to check for evidence of other possible problems that could explain a person’s symptoms, such as a stroke or a brain tumour.
You might have a computerised tomography (CT) scan or a magnetic resonance imaging (MRI) scan, depending on what the doctor determines would be the most helpful as part of the assessment.
Even if a brain scan does not show any obvious changes, this does not mean someone does not have dementia.
Other scans and procedures to diagnose dementia
Other types of scan, such as a SPECT scan or a PET scan, may be recommended if the result of your MRI or CT scan is uncertain.
However, most people will not need these types of scans.
Both SPECT and PET scans look at how the brain functions, and can pick up abnormalities with the blood flow in the brain.
If a specialist is worried that epilepsy may be causing the dementia symptoms, an EEG may be taken to record the brain’s electrical signals (brain activity), but this is rare.
ECG
An ECG may be done to check heart function prior to prescribing any medication.
Sensors attached to the skin are used to detect the electrical signals produced by your heart each time it beats.
Who will I see on the day?
There are a number of different people who may be involved in your memory assessment. Here are some explanations of what they do.
Doctors
Old age psychiatrists
Psychiatrists who specialise in the mental health of older people, and also dementia. They may sometimes offer support to younger people with dementia.
General adult psychiatrists
Specialists in diagnosing and treating a wide range of mental health problems, including dementia. If you are under 65 years of age, you may be referred to one of these psychiatrists to help with the diagnosis.
Geriatricians
Specialists in the care of older people, including physical illnesses and disabilities. You may be referred to one of these specialists to see whether your symptoms are due to a condition other than (or as well as) dementia.
Neurologists
Specialists in diseases of the brain and nervous system. Some neurologists have particular experience in diagnosing dementia. They tend to see younger people and those with less common types of dementia.
Consultant
Other specialists
Memory nurses
Professionals who coordinate the journey through the memory clinic assessment and providing support and advice, alongside the assessment.
Psychologists
Occupational therapists
Social workers
Dementia advisors
Speech and language therapists
Professionals who ensure that communication needs are met in the memory assessment process.
Download our printable guide
This guide contains information and advice on staying well while waiting for a memory assessment, as well as a range of exercises you can complete to help you decide on what’s right for you.
