Mobile Memory Clinic helping GPs diagnose dementia

mobile memory clinicAs Dementia awareness week draws to a close and World Alzheimers Day is recognised on September 21 it is an opportune time to look at a partnership project between Hunter Medicare Local and the University of Newcastle.

The two organisations were successful in receiving a grant from the Department of Health and Ageing to undertake an Aged Care Nurse Practitioner Model of Practice project.

Helga Merl is the Nurse Practitioner working on this project and pioneering a new and innovative model of care called the “Mobile Memory Clinic” which is aimed at working with GPs and Practice Nurses to lift the low rates of dementia diagnosis within the Primary Care.

Australian GPs are as good as any in the world at identifying people at risk of dementia, identifying between 48-67% for mild dementia and 76 – 85% for moderate to severe dementia. Once identified diagnosing dementia is the real challenge. The nature of general practice means GPs lack the time and often the specialist knowledge necessary to diagnose dementia early. Consequently the delay from relaying symptoms to the GP to diagnosis is on average (in NSW) 37 months.
Early and timely diagnosis enables access to vital treatment and intervention strategies that can reduce the impact of the disease, at a time when the person retains decision making capacity and can actively participate in future life planning. Despite growing consumer and health sector demand for early and timely diagnosis, screening and diagnosis rates have not improved over the last 10 to 15 years
Nurse Practitioners (NPs) are an emergent and extremely underutilised segment of the Australian health care system. Operating as Advance Practice Nurses and educated with Master degrees, these nurses undergo a rigorous Australian Health Practitioners Registration Authority endorsement process to enable best practice diagnosis and management of Dementia, they may attain authority to prescribe and provide reimbursable services under the Medicare Benefits Scheme. NPs provide high levels of patient care, health outcomes and satisfaction, on par with GPs .

Our Hunter ML NP “ Mobile Memory Clinic” is being evaluated by Canberra University as part of the national program in regards to its ability to Demonstrate effective, economical & sustainable Model of Practice; Facilitate the growth of the aged care NP workforce and Improve access to primary health care. The University of Newcastle is also evaluating the project.
Operational since May this year, the Mobile Memory Clinic accepts referrals from GPs, Practice Nurses, Connecting Care staff (via the GP) and Aboriginal Health staff primarily in the Port Stephens are for people at risk of Dementia. The NP Provides comprehensive health assessment, differential diagnosis and collaborative management plans. This project is paving the way for early and timely diagnosis which leads to better outcomes for people with Dementia, their carers and families and the primary care services that support them.

Photo above showssome happy customers from the Sturgeon Street Practice, Raymond Terrace which has referred around 20 patients. Practice Nurse Rose -middle back, Dr Guy Streeter Smith – back right and Odette – Practice Manager sitting.

Child Mental Health Service

CMHSThis week shines a light on mental health as both World Suicide Prevention Day and R U OK? Day approach. report that around 2,300 suicides are recorded each year in Australia. Such alarming figures highlight the importance of addressing the mental health of our children.

Childhood is a crucial time for growing healthy minds with experiences in the early childhood years affecting the long-term mental health of the individual.

The Hunter Medicare Local Child Mental Health Service (CMHS) is accepting referrals from GPs, Paediatricians and Psychiatrists.

Other professionals working with children from Hunter New England Local Health District, the Department of Education, Non-government Organisations and Early Childhood centres are encouraged to direct children and their parents or carers to their GP or specialist to organise a referral and may be able to make a provisional referral to Hunter Medicare Local directly.

CMHS aims to provide eligible children; 12 years old or younger, with high quality, short term evidence based psychological strategies within a primary care setting. CMHS is able to offer this service to children with, or at risk of developing, a mild to moderate mental, childhood behavioural or emotional disorder that could benefit from short term psychological intervention of 6 – 12 sessions including the following presenting concerns:

  • Anxiety
  • Post Traumatic Stress
  • Depression and mood disorders
  • Adjustment Disorder
  • Parent-Child relationship concerns and attachment disorders
  • Parental assistance
  • Eating disorders (early in their presentation)
  • Feedings Disorders
  • Enuresis
  • Encopresis
  • Selective Mutism
  • Somatoform disorders
  • Chronic Fatigue Syndrome
  • Sleep disorders
  • Bereavement
  • Childhood behavioural problems
  • Tic disorders (e.g. Tourette’s syndrome)
  • Sexual disorders
  • Substance use disorders

Referral advice is available to GPs, Paediatricians and Psychiatrists who wish to make a referral to the Child Mental Health Service, to enable them to access the most appropriate and timely care for their patients.

For further information contact the Referral Management Team on (02) 4926 0529

Suicide and self-harm: what can we do?

suicideSuicide and deliberate self-harm continue to be a significant public mental health issue. Research has shown that tragically out of an estimated 68% of people who commit suicide, they did not necessarily meet criteria for having a mental disorder.

Hunter Medicare Local has for many years conducted the Suicide and Self Harm program which aims to reduce the risk of this happening. The program is delivered by specialist trained Clinical Psychologists who can provide support to GPs to assist them in caring for their at-risk patients.

The Suicide Fast Response Service started as a pilot program and has been providing clinical services since early January, 2009. It is a responsive service available to patients assessed by a GP to be at moderate to high-risk of suicide or who have attempted suicide or deliberate self-harm.

  • The service is designed for patients who express recent onset suicidal ideation and are likely to have experienced a recent stressful change in situation or life event. The person may not have an established mental illness.
  • Patients will be contacted by telephone within 24 hours and, if eligible, will be offered appointments within 72 hours. Unlimited sessions can be offered for up to two months.
  • The service is not able to see people for whom suicidal or self-harm behaviours are part of a longer term pattern of behaviour or mental illness, who are already under the care of Area Health Mental Health Services or who need to go to hospital.

Last year the program managed over 250 people and offered nearly 1000 sessions.

In the Hunter we have seen a significant increase in the awareness of GPs around identifying risk and we feel this can be partly attributed  to GPs becoming more confident because they have access to a fast response referral pathway and also because they feel supported in managing their at risk patients.

For further information contact the Referral Management Team on (02) 4926 0529

1.1 million Australians have difficulty communicating

Little girl learningHunter Medicare Local would like to take the opportunity during Speech Pathology Week to acknowledge all the fantastic work that speech pathologists are performing.

Speech Pathology Week is the annual week that raises awareness about the hundreds of thousands of Australians who live with a communication or swallowing difficulty, as well as the professionals who work with them to improve or regain their quality of life.

This week Shae Rodgers from The Newcastle Learning and Development Clinic has been working with children to colour in handprints and encouraging families to share stories of how speech therapy has helped their child.

Four-year-old Lachlan Pearson has Autism and accesses speech pathology intervention at Small TALK speech therapy. Lachlan’s mother Clare shares how speech therapy is helping her son:

“Since Lachlan has been having therapy sessions with Shae he has improved so much.

When Lachlan started with Shae he only had a few words, couldn’t point to his shirt, shorts etc.

The therapy method (Applied Behaviour Analysis; ABA) Shae is using with Lachlan is working so well, he has more words and is trying every day to say new words. I love that Shae sits Lachlan at a desk and actually does speech work with him, doesn’t make it a play session with toys.

He seems to becoming more confident and wanting to try and talk.

If he can’t say the word then he is pointing to what he is wanting or doing the basic signing, the frustration is slowly being reduced with the ease of letting us know what he is wanting. Reported Lachlan’s mother, Clare.

Michelle Santarelli is a paediatric speech pathologist at Early Start Speech Pathology in Wallsend.

Michelle says they are a number of common questions parents ask and they all warrant speech pathology investigation. These include:

  • My child has had constant ear infections and is still not using many words at 2 years old
  • My child is a fussy eater and won’t tolerate anything except puree foods at 18 months old
  • My child won’t listen to me when I give him an instruction; I think he’s just ignoring me.
  • My child is having difficulties making friendships at school
  • My child is struggling with her reading and spelling and is falling behind her peers at school.
  • My child always confuses words in his sentences, will tend to go off on tangents when talking or has trouble asking questions

 Speech Pathology is such a valuable service that it is important that as many people as possible have access to it. One of the ways Hunter Medicare Local is improving access for rural communities to allied health services such as speech pathology is the through the Rural Allied Health program.

The Rural Allied Health program aims is to improve the health and wellbeing of people in rural and remote Australia by providing and maintaining access to supplementary allied health and primary care services that are based on identified health needs communities.

In Forster and surrounding Rachel Taylor-Notley, is a Speech Pathologist who is able to provide the same type of services as Shae and Michelle.

More information on the Rural Allied health program is available by contacting Hunter Medicare Local on (02) 4925 2259.

Suicide kills more people than road accidents

cyber-bullying_girlIt’s a sad but true fact that suicide kills more people than road accidents.

The Black Dog Institute reports that every day, at least six Australians die from suicide and a further thirty people will attempt to take their own life.

This week Australian Institute of Health and Welfare (AIHW) announced that there has been an increase in young women being admitted to hospital for self-harm. AIHW report that the number of women aged between 15 and 24 who have injured themselves so badly they need hospital treatment has increased by more than 50 per cent since 2000.

In a comment about the increase, AIHW spokesperson Prof James Harrison said “We have to ask whether changes in rates there are due to changes in the self-harming behaviour of young women or whether they are to do with changes in the nature of medication that young women are taking.”

News of this study falls in line with the announcement of the shock-twist in the investigations into the suicide of 14-year-old English girl Hannah Smith. In an inquiry into the matter, has uncovered that 98per cent of the abusive messages sent to Hannah came from the same IP address as her computer. Such news highlights the findings from research conducted by Massachusetts Aggression Reduction Centre who reported that up to 10 per cent of first-year university students had ”falsely posted a cruel remark against themselves, or cyber bullied themselves, during high school”.

In 2010, Danah Boyd, a leading social media researcher, wrote about the emerging trend; Digital self-harming, that involved teens anonymously posting vicious questions to themselves, before publicly answering them. In a blog post about Digital self-harming, Boyd states “using the anonymous Q&A system, teens are able to make it appear like they’re getting attacked, which results in them getting attention in different ways”. Boyd advises that although digital self-harm is not solely the explanation behind the majority of negative comments, its existence should be a warning to all; especially parents who are trying to address bullying within their households.

If you need urgent support or are worried about someone, please contact your local doctor or visit R U OK? for a list of national crisis lines and help lines.

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