Patients with dementia and their carers

Clinical guidelines for general practitioners' care of patients with dementia still living in the community (not in hostels or nursing homes) were used in an educational program for general practitioners. At the same time information was obtained about the current health status, needs, and management of such patients and their carers. Eight general practitioners audited a total of 25 patients. Carer questionnaires were returned from 30 carers recruited by the general practitioners and 77 recruited by Alzheimer's Australia NSW. Many of the audit results are as expected, but some raise important issues. The diagnosis was not fully established for 20% of patients and the MMSE score not known by the general practitioner for 56%. Home safety had not been assessed for 44%. Legal matters such as driving or guardianship had not been considered for more than half. Most carers felt supported by their general practitioner in their role as carer, but services that would have been useful were not available to 23%, and most felt that being a carer had affected their own health. The small number of participants means that the audit results come from too few general practitioners to be reliably representative, but they do provide an indication of likely general results, and indicate priority areas for improved care.