A model of a community-based psychological service to help people with early-stage dementia

In this paper, I propose that there needs to be an off-the-shelf model available of good practice regarding the help offered to older people who have become concerned about apparent cognitive difficulties. The framework suggested is that one mental health professional provides long-term support to each individual. Initial investigations should include thorough physical and psychological workups, so that relevant conditions, such as diabetes or grief, for example, receive appropriate attention. The psychological workup should lead to the therapist and client developing a case formulation and thence to discussing the most appropriate treatment plan, be it individual, group or family interventions. Additionally, the client would be made aware of positive steps they can take such as exercise, a healthy diet, and socialising, which research has clearly shown to decrease the risk of dementia. The types and intensity of interventions are likely to vary across time as problems are tackled and an outcome reached. However, the future may well throw up new problems that need addressing and the nature of the intervention change. While this model may appear to be expensive, the long-term relationship; and the security it brings to the client and their circle is likely to decrease the need for emergency resources, and, in the long run, the need for residential care. Across health budgets, it is likely that it would save money.