Dementia Risk & Cognitive Support DEMENTIA RISK & COGNITIVE SUPPORT (QMS-F071) Contact Document Ref: QMS-F071 (Dementia Risk & Cognitive Support) Version: 1.0 Confidentiality Level: HIGH (Medical Records) CQC Alignment: Responsive (Person-Centred Care) Service User Full NameService User ID NumberOperating Local Authority- Select -HaringeyIslingtonWaltham ForestBarnetOtherCare Funding & Financial Arrangements- Select -Local Authority Managed (Direct Commissioning)NHS Funded (Continuing Healthcare - CHC)Direct Payments (Personal Budgets)Self-Funded (Full Cost)OtherSECTION 1 - Cognitive Baseline & Legal StatusCognitive Baseline- Select -No cognitive impairment observedMild memory loss / Age-related decline (Undiagnosed)Formal Dementia Diagnosis (Early Stage)Formal Dementia Diagnosis (Mid Stage)Formal Dementia Diagnosis (Advanced / Late Stage)Delirium / Acute confusion (e.g., secondary to infection)Diagnosed Dementia Sub-Type- Select -Alzheimer's DiseaseVascular DementiaLewy Body DementiaFrontotemporal DementiaMixed DementiaUnknown / Awaiting Memory Clinic assessmentIs there a registered Lasting Power of Attorney (LPA) for Health & Welfare in place?- Select -Yes (Copy of LPA must be retained in the care file)NoUnsure / Being investigatedSECTION 2 - Behavioural and Psychological ObservationsIdentify any behaviours currently exhibited by the service user: Short-term memory loss (Repetitive questioning) Disorientation to time or place Wandering / Leaving the property unsafely Sundowning (Increased confusion in late afternoon/evening) Agitation / Restlessness Verbal aggression or shouting Physical resistance to care interventions Hallucinations or delusions Hoarding behaviour None of the aboveKnown Triggers for AgitationSECTION 3 - Communication & De-escalation StrategiesRecommended Communication Strategies Validation Therapy (Entering their reality, not correcting them) Reality Orientation (Gently reminding them of current time/place) Use of short, simple sentences (One instruction at a time) Visual cues (Pointing, showing objects) Maintaining consistent eye contact at their level Allowing extra processing time (Wait 10 seconds for a response)Is there a risk of the service user refusing essential care (e.g., medication, food, hygiene)?- Select -YesNoMandatory Mental Capacity Trigger- Select -I confirm that a Mental Capacity Assessment (Form 43) will be completed to address the refusal of essential care.Care Refusal ProtocolSECTION 4 - Risk Control & Sign-offSpecialist Professional Involvement- Select -None currently involvedCommunity Mental Health Team (CMHT)Memory ClinicAdmiral NurseSocial Worker (Safeguarding)Mandatory Action Plan / Instructions for Care WorkersAssessor NameDate of AssessmentSave Cognitive Assessment
