The early identification of cognitive impairment:A stakeholder evaluation of a ‘Dementia Awareness Service’in Belfast

The early and accurate identification of dementia helps to ensure the delivery of appropriate treatment and allows people with dementia and their carers to plan for the future. This article describes a research evaluation of a new screening, assessment and referral service for people with early-stage dementia and their carers who reside in one of Northern Ireland’s integrated health and social services trusts. A total of 435 referrals were made to the service during the first 33 months; most were female (70%) with an average age of 80 (SD = 7.68) and a mild/moderate (71%) cognitive impairment (mean Mini-mental State Examination score of 20.21 (SD = 6.10)). A research interview was conducted with 20 consecutive service users and their carers (n = 21) following their initial assessment by a community psychiatric nurse and again four months later. Users recorded an overall improvement in self-reported quality of life and their use of health and social services remained unchanged. Carers valued highly the information and support provided by the project; their QoL improved and ‘stress and strain’ (as measured by the General Health Questionnaire-30 and Carers’ Checklist) decreased. Generally, stakeholders such as referral agents reported that the new service made an important contribution to dementia care, although some professionals thought that the service needed to be better ‘networked’ in order to avoid duplication of resources. Overall, the findings from this evaluation help to address the lack of available information about ways in which to organize and deliver early-stage dementia care.