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Should old age psychiatry develop memory clinics? A comparison with domiciliary work

Yeatman Hospital, Sherborne, Dorset DT9 3JU, UK.

Diane Beavis, Research Nurse in Old Age Psychiatry

Forston Clinic, Herrison, Dorset DT2 9TB

John Dyer, Nurse Specialist in Neuropsychiatry

The Stewart Wing, Yeatman Hospital, Sherborne, Dorset DT9 3JU

Sue Ball, Associate Specialist Psychiatrist

The Stewart Wing, Yeatman Hospital, Sherborne, Dorset DT9 3JU, UK

Declaration of interest

This study and research nurse post was funded as a task-linked Culyer research project.

Correspondence: E-mail: steve.simpson{at}northdorset-pct.nhs.uk

AIMS AND METHOD

Memory clinics have become very popular in old age psychiatry and there is some pressure for them to be developed in old age services. However, there is little evidence to suggest that they are more advantageous over the traditional domiciliary visits or who should be seen in clinic. This was a naturalistic comparison of 76 consecutive new referrals to a memory clinic, with 74 consecutive new domiciliary requests within the same service over the same period of time. A retrospective case note review collected the clinical features and an 18-month prospective follow-up examined the subsequent clinical management.

CLINICAL IMPLICATIONS

The two groups were characterised more by their similarities than their differences. However, the domiciliary group had greater behavioural and psychological complications. The memory clinic patients were less likely to receive psychotropic medication and here more likely to be followed up.

RESULTS

We conclude that memory clinics might be less suitable for patients with prominent psychiatric complications. Memory clinics could complement the domiciliary model by providing early psychosocial/neuropsychiatric approaches, although this is likely to lead to an increased clinical case-load.

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