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44 Australian Journal of Dementia Care October/November 2016 Vol 5 No 5
hospital outpatient setting, however
community or residential care settings
would be more appropriate environments
in which to run the CST program as they
allow for continuity of care in an
environment supportive of participants’
ongoing needs.
Following the pilot study, CST
facilitators held training workshops with
community and residential care staff from
The Whiddon Group. The organisation
then trialled CST across a number of its
community and residential care facilities in
NSW in 2015. Karn Nelson (Whiddon
Group’s Executive General Manager
Strategic Policy and Research) reports that
the CST programs have been highly
successful and the organisation is rolling
out its version of the program, which it
calls Chat, Stories & Tea, in all its services
this year (see report p43).
Conclusion
CST offers a cost-effective early
intervention program suitable for people
with a mild to moderate dementia. The
pilot study demonstrated the ease of use
in implementing CST in an Australian
setting.
Acknowledgments
This project was funded by the Dementia
Collaborative Research Centre: Assessment and
Better Care as part of an Australian Government
initiative.
References
Aguirre E, Spector A, Streater A, Hoe J, Woods
RT (2012) Making a difference 2: an evidence-
based group program to offer maintenance
cognitive stimulation therapy (CST) to people with
dementia: the manual for group leaders, volume 2.
London: Hawker Publications.
Kanareck D, Mathie S, McCaskie H, Narunsky N,
Finlay J, Draper B (2015) Cognitive Stimulation
Therapy – a pilot Australian adaptation. Australian
Journal of Dementia Care 4(1) 33-36.
Kanareck D, Narunsky N, Draper B (2015) 1 2 3
Australian CST: Australian adaptations for
cognitive stimulation therapy. A compendium of
Australian content to accompany Making a
difference and Making a difference 2. Sydney:
Dementia Collaborative Research Centre:
Assessment and Better Care, UNSW Australia.
Available at:
resource/cognitive-stimulation-therapy/.
Spector A, Thorgrimsen L, Woods B and Orrell M
(2006) Making a difference: an evidence-based
group program to offer Cognitive Stimulation
therapy (CST) to people with dementia. London:
Hawker Publications.
Daniella Kanareck (social worker), Natalie
Narunsky (occupational therapist) and Professor
Brian Draper (old age psychiatrist) are from the
Aged Care Psychiatry Service, Eastern Suburbs
Mental Health Services, Sydney. To follow up on
this article contact Daniella at:
Unfortunately, many people with
dementia report a significant delay to
receiving a confirmed diagnosis of
dementia – up to three years from first
onset of possible symptoms such as
memory concerns (Phillips et al 2011). This
time lag leads to uncertainty for
individuals and their families. Akey issue
may be general practitioner (GP)
knowledge about dementia.
Dr Allan Shell, an academic GP and
visiting Fellow to the Dementia
Collaborative Research Centre: Assessment
and Better Care, leads pioneering
Australian work to improve a more timely
diagnosis and better management of
dementia in primary care settings. With
advice and support from specialist
colleagues in psycho-geriatric clinical
practice and those involved in dementia
research, Dr Shell developed an education
program to enhance GP knowledge of
dementia, approved by the Royal
Australian College of General Practitioners
(RACGP) and theAustralian College of
Rural and Remote Medicine (ACRRM).
It offers four options to help GPs assess
and better understand dementia risk:
•Accredited (six hour) Dementia
WorkshopActive LearningModule
(ALM) – delivered in person by a
facilitator.
•Accredited online version of theALM.
• Train-the-trainer program to enable GPs
to deliver theALMmaterial to local
practices and regions.
•Online ‘dementia-screening-prompt’ tool
for use in GP practices.
In the four years since the Timely
Diagnosis program started in 2012 more
than 1800 GPs have attended the face-to-
face WorkshopALMs at 40 different
meeting sites aroundAustralia. Also, 20
GPs have attended the ‘train-the-trainer’
ALM, and some of these are now
delivering the workshop acrossAustralia.
More than 14 specialists are involved, as
associated facilitators, to assist the GPs
presenting the WorkshopALM – in
addition to those being presented by Dr
Shell with a Specialist colleague.
More than 1500 GPs have completed the
onlineALM since its launch in June 2013. It
was developed with the assistance of
approvedmedical education provider
Genesis Ed, and is available at www.Think
and via the DCRCs’ new
DementiaKT Hub website at http://
diagnosis-of-dementia/.
Dementia-screening-prompt tool
Akey milestone for the project was the
launch of the online ‘dementia-screening-
prompt’ tool. It was developed and
incorporated into Best Practice software (a
widely used commercial product), giving a
potential reach of more than 3000 medical
clinic customers acrossAustralia.
The tool assists a GP to measure, record
and report individual dementia risk
through a risk assessment prompt. It
includes information for daily living,
dementia risk factors, advanced care
planning and referral information, and
links to education materials for families
and people with dementia.
Feedback from GPs
The Timely Diagnosis project has collected
evaluations fromGPs. From surveys of
more than 1000 GPs who have completed
the WorkshopALM, almost 90% reported
improved awareness of dementia – and an
appreciation for the relevance of the
training material for assessment, diagnosis
and better management of dementia in
their practice. Feedback fromGPs
completing the onlineALMhas been
similarly positive.
The Timely Diagnosis project is making
great progress, helping professionals in
general practice understand, screen and
manage dementia better. It builds on other
DCRC-led activities for GPs, such as the
14 Essentials of Dementia Care (http://
essentials/) and the projects led by
Professor Dimity Pond exploring the roles
of practice nurses.
Acknowledgment
Key funding for the Timely Diagnosis project has
been received from project partners Alzheimer’s
Australia and the Dementia Training Study Centre
VIC/TAS.
Measuring GPs’ attitudes and confidence
towards dementia see p65.
Phillips J, Pond D, Goode
SM (2011) Timely diagnosis
of dementia: can we do
better? a report for
Alzheimer’s Australia, Paper
24. Available at: www.
files/Timely_Diagnosis_
Can_we_do_better.pdf
DCRC SPEC I AL I SSUE : THE B I G P I CTURE I N DEMENT I A RESEARCH
Dementia is not yet curable, but the benefits of early
diagnosis include access to specialised health care,
appropriate interventions and local support services
GP education supports timely diagnosis
Dr Allan Shell