Services provided:
Specialist Memory Services offers comprehensive initial diagnostic assessments involving medical specialist (geriatrician or neurologist), allied health and nursing staff
Expert imaging and investigation review using the latest diagnostic techniques
Collaborative multidisciplinary case discussions and care planning
Ongoing specialist review appointments to monitor progression of your condition and symptoms over time, review treatment options and treatment response, and discuss referral to research trials
Our post-diagnosis services are individualised to address the needs and priorities of each patient, but may include:
Follow up appointments to discuss the diagnosis in more detail
• 1:1 dementia education
• Carer support sessions
• Assistance with future planning and linking to relevant community services and resources
• Diagnostic Assessments
Neuropsychology diagnostic assessments can determine the nature and severity of any changes in cognitive function. Assessments may assist identifying an emerging neurodegenerative process such as Alzheimer’s disease or other types of dementia. They may also indicate whether other factors such as lowered mood are the primary issues impacting an individual’s cognitive and daily function.
• Cognitive Characterisation/Strengths & Weaknesses Assessment
The results of a neuropsychology assessment provide a useful framework for the provision of compensatory strategies tailored to an individual’s areas of strengths and weaknesses. This can enhance an individual’s everyday function and/or rehabilitation, along with assisting carers, partners and treatment agencies to understand and work effectively with the individual.
• Capacity Assessments
Neuropsychology can investigate and make comment on whether a person’s cognitive impairment impacts on their ability to make informed decisions about a range of significant life issues. These include determining a person’s decision making capacity to appoint an Enduring Power of Attorney, their capacity to make financial, medical and/or lifestyle decisions, their capacity to make or change a will (Testamentary Capacity) and their capacity to instruct a solicitor and engage in legal proceedings.
• Medico-legal/Forensic Neuropsychology Assessment
Neuropsychological assessments and reports are available for medico-legal/forensic purposes. For example, these include assessment of cognitive impairment due to acquired brain injury (ABI) that may impact a person’s cognitive function. Assessments may assist in determining the link between cognitive impairment and an individual’s offending behaviour. Specific recommendations are also provided to assist working with clients with brain injury and resultant cognitive impairment.
Our OT specialises in cognitive impairment and dementia. We offer a range of cognition and dementia-focused OT services, supporting patients and families from pre-diagnosis through to late-stage dementia, including:
• Functional & home assessments**
• Strategies to compensate for memory loss and changing abilities for daily activities
• Advice on safety, accessibility and falls prevention in cognitive impairment and dementia
• Environmental modifications and strategies to compensate for cognitive changes
• Other dementia-related OT interventions with both the patient and carer including COPE (Care of People with Dementia in their Environments) program
• Dementia risk-reduction education and individualised support
** limited areas only, travel costs apply
• Relevant health assessments
• My Aged Care and Home Care Package liaison/referrals /assessments
• Liaison and referrals to support services
• Medication management advice
• Continence support
• Behaviour support
Provided by a psychologist with extensive experience in the dementia field.
Provision of supportive psychotherapy for:
• Individuals diagnosed with dementia. Psychological distress is common in individual’s adjusting to a diagnosis of dementia. The use of evidence-based psychotherapy such as Cognitive Behavioural Therapy (CBT) can effectively treat symptoms of depression and anxiety which are commonly experienced by individuals with dementia. Appropriate management of an individual’s psychological distress can enhance their cognitive function, independence and quality of life.
• Caregivers – a diagnosis of dementia can have a widespread psychological toll on those nearest the patient. Psychotherapy can therefore be very helpful to support a caregiver’s emotional needs and maintain their own wellbeing. This can include providing assistance to caregivers adjusting to changes of loved-ones and assist managing symptoms of depression and anxiety.
• Individuals worried they may be developing dementia. Treatment of underlying anxiety can enhance an individual’s cognitive/thinking abilities and enhance their quality of life.
To find out more about dementia diagnosis and dementia management click here.
SMS Initial diagnostic evaluation process
1st Appointment: initial diagnostic assessment
* General information only, as all appointments are tailored to each patient’s individual needs and preferences.
Please allow at least two hours for your first appointment, as this will involve:
– Cognitive occupational therapist assessment (40 minutes):
SMS cognitive OT collating background information including the reason for referral, a patient and (with consent) family interview to gather social, family, work history and current functional status, completion of screening tools and questionnaires, handover to Specialist.
– Nursing health check (15 minutes):
This involves completing general health measures such as checking blood pressure, pulse rate and rhythm, weight, reviewing medications and administering any relevant health questionnaires.
– Specialist review (40 minutes):
This involves SMS medical specialist (Geriatrician or neurologist) completing focused history taking, detailed medical and cognitive assessment, expert review of imaging and other investigations (please link to investigations section in education and resources tab) and consolidation of all diagnostic information collected over the course of the appointment.
Comprehensive multidisciplinary case conference
Each case is presented to the SMS team for expert multidisciplinary input, including review of all relevant imaging and screening test results. A summary report is sent back to the referring GP within a day of your appointment, clearly outlining the management plan and any schedule for review.
In between 1st and 2nd appointment we complete any necessary investigations. If we identify a need for more detailed assessment of cognition, a comprehensive neuropsychology assessment with our expert Clinical Neuropsychologist is recommended.
Further investigations may include MRI-Brain, FDG PET and further blood tests (all are partial or fully Medicare rebated services). You can find out more about these investigations here.
2nd appointment: Discussion of assessment results and diagnosis
Please allow up to 1 hour for your second appointment, as this will involve:
Feedback and discussion of your assessment results, including the results of any further tests and/or imaging completed.
In most cases we are able to formalise the diagnosis at this second appointment and will have all treating clinicians, including SMS medical specialist, OT and neuropsychologist present to participate in the appointment.
At this appointment we will review assessment results, including any neuropsychological assessment, scan results, relevant blood tests etc. and commence initial discussions on treatments and future planning.
We encourage family members to attend with the patient to provide support and assist with information retention.
In some cases, the diagnosis is not clear by the second appointment and additional tests may be needed and/or further time to monitor symptom progression. In this case a specialist review will be booked and further management plan discussed.
*General information only, as all appointments are tailored to each patient’s individual needs and preferences.
Allied Health/Nursing review appointment
Please allow 40 minutes for any allied health/nursing review appointments. Timing will vary depending on the issues to be discussed.
We understand that there is often a lot to find out and discuss when a diagnosis of dementia or cognitive impairment is made.
In addition to medical management, patients and families may have questions about how the diagnosis will impact their daily lives, what services and supports are available, how to minimise further decline, planning for the future and risk management/safety concerns.
We offer follow up appointments with our specialist OT and/or nurse to support information provision and offer opportunity to ask questions and address the specific priorities of each patient.
A follow up appointment can reinforce the previous discussion points and address any further questions that have arisen in between appointments.
Some families need extra time to come to terms with the diagnosis and digest the information discussed at the feedback appointment, therefore follow up appointments with our specialist allied health/nursing staff can be made at any point in the dementia journey.
*General information only, as all appointments are tailored to each patient’s individual needs and preferences.
Patients attending SMS for diagnostic assessment have access to:
- Consultations with medical, allied health and nursing clinicians that enable us to obtain a full picture of each patient’s cognition, behaviour, background, lifestyle, medical issues and the impact of changes on their daily life.
- Administration of a range of assessment tools and questionnaires with both the patient and, with their consent, a family member or close friend to clearly detail their current status and any areas of concern.
- Detailed neuropsychological assessment that can comprehensively assess a person’s cognitive abilities.
- In-depth review of any reversible factors including mood, medications or other health issues.
- Assessment of the impact of any cognitive changes on the patient’s ability to function in daily life, and then strategies and practical advice to address these. Where appropriate, home based assessments are available*
- Evidence based advice regarding dementia risk-reduction strategies
- A detailed diagnostic discussion with both the patient and (where appropriate) their family members to outline the assessment findings and collaboratively develop a plan for ongoing management and treatment.
- Information and assistance in linking to relevant community supports
- Assistance with planning for the future, including relevant medico-legal aspects
*home-based appointments are available within set boundaries only
Patients attending SMS for surveillance/ongoing management of dementia have access to:
- Regular review with medical, allied health and nursing clinicians to monitor and address any medical, psychosocial and practical needs. SMS staff review each patient’s cognition, behaviour, lifestyle, medical issues and the impact of the condition on their daily life.
- Repeat assessments as indicated to monitor any progression in symptoms and to aid management.
- Assessment of response to memory boosting medications prescribed for certain types of dementia.
- 1:1 sessions, including with family, that provide opportunity for dementia education and to build skills in dementia management.
- Review of the patient’s home*, existing social supports, community service options and assistance to access dementia specific services.
- Guidance around care and safety issues that can arise when living with dementia including home safety, driving, falls prevention, carer education and support, advice about respite options, meaningful activity and adjusting to the changes brought by dementia.
- Assistance in linking to relevant community supports
- Assistance with planning for the future, including medico-legal aspects.
*home-based appointments are available within set geographical boundaries only
You may wish to review the SMS website, particularly the section above which outlines our appointment processes.
Think about your goals and what you would like addressed at your SMS appointment. You may wish to write some brief notes about any concerns or questions to bring on the day.
We find it useful to consult with a family member or close friend to hear their perspective and observations about any changes in your memory or thinking, but we won’t do this without your consent. Consider which (if any) family members you wish to have attend your SMS appointments. Arrange ahead of time for chosen family members to accompany you on the day.
Apart from these suggestions, there is no specific preparation required.
To each appointment please bring:
- Your Medicare card
- Glasses
- Hearing aids
- Mobility aids
- Current medications or a current medication list
- Relevant scans or any other test results or reports including details of other Specialists involved in your care
We understand that having a loved one experience symptoms of cognitive decline or dementia is concerning for families, and relatives are often keen to be involved in SMS appointments.
We value family members’ input and participation, both for supporting the person undergoing assessment/treatment, and also in providing another perspective and observations of any changes noticed day-to-day.
Of course, any involvement of family members in a patient’s appointments requires the consent of the patient involved, and this will be discussed prior to commencement of the assessment.
How to assist your relative to prepare for their appointment:
Some patients find it helpful to know what to expect in advance of their appointment at SMS. In such cases family may wish to discuss the SMS assessment process with their loved one, including the details above.
In some cases however, detailed discussions and repeated information about an upcoming assessment can be anxiety provoking and overwhelming for the person with cognitive/behaviour changes. This is particularly the case when the person does not notice the changes themselves.
In such cases, we recommend family members avoid giving excessive explanations or attempts to convince the person about the changes that are noticed.
Instead, remind your relative of the appointment only close to the time (e.g. the night before), try to keep information positive (e.g. mention how friendly the SMS staff appear on the website!), and focus on the potential for beneficial treatment/advice to support the person to continue to live and manage well at home.
To assist in our information gathering, it is very helpful for attending family members to give some thought to the following in preparation for their relative’s first appointment:
– The main changes you have noticed in your loved one, such as differences in them now compared to 10 years ago
– Any areas of concern in daily life, such as difficulty with tasks and activities they once found easy, and changes in behaviour
– The timeframe over which changes occurred and whether they are worsening, stable or improving
– Any factors that you feel are relevant such as medical issues, mood issues, major life changes
With the patient’s consent we involve family members at various stages of assessment and management. This may include having family complete questionnaires detailing any changes observed, participating in clinical interviews and assessments, and in follow up and education sessions as desired.
Fees + Billing
Out-of-pocket costs will be discussed at the time of booking. Please ensure you are aware of the fee when booking your appointment.
For telehealth appointments our receptionist will call you after your appointment to process payment over the phone.
If you have registered your bank account details with Medicare your rebate will be sent directly to your nominated account. Alternatively, a receipt can be provided for you to claim back your Medicare rebate.
Please contact SMS on at least 48 hours prior to your scheduled appointment for any cancellation. Patients who fail to provide 48 hours notice of cancellation may incur a non-attendance fee. Subsequent appointments will not be booked until any non-attendance fees are settled.
An additional fee will be incurred for completion of forms not eligible for Medicare rebate. Please advise our receptionist when making an appointment for completion of forms to ensure we can inform you of any fees and can allocate adequate time for form completion during your appointment.
Allied health services eligible for a Medicare rebate are available only for patients with a chronic medical condition and complex care needs under a Chronic Disease Management Plan. Eligibility for a Medicare plan and referrals to nominated allied health practitioners are determined by the GP. It is recommended that patients discuss their eligibility for specific rebates with their GP. Medicare rebates do not cover the full cost of SMS allied health services and out-of-pocket costs will be discussed at the time of booking. Please ensure you are aware of the fee when booking your appointment.
Patients eligible for other funding streams including Home Care Packages and NDIS may be able to use their funding for SMS allied health services. Please call us to discuss your specific situation.
Patients eligible for other funding streams including Home Care Packages and NDIS may be able to use their funding for SMS nursing services. Please call us to discuss your specific situation.
