Table 1

Enablers and barriers in the identification, assessment, and management of dementia

ENABLERSBARRIERS

  • Family member corroboration reporting on ADLs

  • Family member initiation of investigation of memory problems

  • Assessment tools (eg, MOCA, MMSE, Dementia Caregiver’s Toolbox)

  • Guidelines

  • Other staff reporting missed appointments; change in routine for patient

  • OT, PT, nursing staff providing feedback on patient’s cognitive states

  • Time multiple short office visits facilitate thorough investigations

  • Depression scales

  • Specialist referrals and clinics

  • Comorbidity

  • Family corroborating evidence

  • Laboratory results

  • CT

  • Memory clinics

  • Pharmacists

  • Expert opinion

  • Community agencies

  • Lack of family member involvement in patient care

  • Complexity of the brain

  • Access to specialists

  • Guidelines

  • Understanding the clinical utility of tools (eg, MMSE)

  • Multiple medical conditions

  • Missed appointments

  • Office setting vs home setting as optimal

  • Uncertainty with diagnosis

  • Access to CT

  • Time

  • Level of experience and knowledge base about dementia

  • Patient’s lack of insight

  • Medications (clinical decision about whom to give what, when)

  • Waiting lists for appointments

  • Driving assessment

  • ADLs activities of daily living, CT computed tomography, MMSE Mini-Mental State Examination, MOCA Montreal Cognitive Assessment, OT occupational therapy, PT physiotherapy.