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- Dementia-Friendly Communities Provision, Viewed as a Social Determinant of Health (JGCR / NHS England / WHO)
- International Perspectives on the Possible Impact of the COVID-19 Pandemic and Lockdown on Abuse of the Elderly (JGCR / American Journal of Geriatric Psychiatry / JAGS)
- Updates Relating to the Lancet Commission on Dementia Prevention, Intervention, and Care (Lancet / Alzheimer’s Research and Therapy / Alzheimer’s and Dementia)
- A Brief Review of How the COVID-19 Pandemic Relates to Elderly Care and Research (JGCR)
- Some Speculated / Potential Benefits of COVID-19 (JGCR / BBC Radio 4’s Rethink / BGS)
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Tag Archives: Ethics and Decision-Making
Recent Information on Restraint in Mental Health Trusts, Plus Statistics on Other Safeguarding Topics (BBC News / NHS Digital)
Summary Freedom of information requests made by the Liberal Democrats have revealed that the use of restraint by mental health trusts in England has increased yearly since 2013, despite repeated calls over recent years for restraint to be minimised. It … Continue reading
Posted in Acute Hospitals, BBC News, Commissioning, Community Care, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), In the News, Management of Condition, Mental Health, National, NHS, Person-Centred Care, Quick Insights, Standards, Stroke, UK, Universal Interest
Tagged Abuse, Abuse of Vulnerable Adults, Acute Care, Adult Safeguarding, Adult Safeguarding Concerns and Enquiries, Adult Social Care Analytical Hub, Avoidable Harm, Community and Mental Health Trusts, Councils with Social Services Responsibilities, Culture of Zero-Harm, De-Escalation Techniques, Deprivation of Liberty Safeguards, Deprivation of Liberty Safeguards (DoLS), DoLS in Hospitals, Dr Sridevi Kalidindi: Royal College of Psychiatrists, Ethical Considerations, Ethical Dilemmas, Ethics and Decision-Making, Experimental Statistics, Face-Down Restraint, FOI: Freedom of information, Freedom of Information, Government Policy on Adult Safeguarding, Harm Free Care, Human Rights, Human Rights and Nursing, Identification and Reporting of Problems, Incident Reporting, Least Restrictive Principle, Liberal Democrat MP Norman Lamb: Former Health Minister (Coalition Government), Liberal Democrats, Making Safeguarding Personal (MSP), Medical Ethics, Mental Capacity, Mental Health Hospitals, Mental Health Trusts, Mental Healthcare, Mind, Neglect and Acts of Omission, NHS Digital, NHS Digital (Formerly the Health and Social Care Information Centre), NHS Digital: Annual Report for England (2016-17), NHS Digital: Safeguarding Adults Collection (SAC), NHS Mental Health Trusts in England, Norman Lamb MP, Openness and Transparency, Openness. Transparency, Physical Restraint, Physical Restraint in Hospital Settings, Physical Restraint in Mental Healthcare, Psychiatric Hospitals, Recording and Reporting, Reporting Culture in the NHS, Restraint, Restraint in Health and Adult Social Care, Restraint in Mental Health Trusts, Restrictive Practices, Safeguarding, Safeguarding Adults at Risk, Safeguarding Adults Collection, Safeguarding Adults Collection (SAC): Annual Report for England (2016-17), Safeguarding Adults Principles, Safeguarding Adults Reports, safeguarding Adults Reviews, Safeguarding Adults Reviews (SARs), Safeguarding Older People, Transparency, Transparency and Accountability, Unintended Consequences, Use of Reasonable Force, Vicki Nash: Mind
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Palliative Care in Advanced Dementia (Cochrane Database)
Summary A recent Cochrane review assessed the evidence concerning the effect of palliative care interventions in advanced dementia. As usually happens in rigorous studies of this nature, the authors of this review could find few high quality trials exploring palliative … Continue reading
Posted in Acute Hospitals, Commissioning, Community Care, End of Life Care, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), Integrated Care, International, Management of Condition, Models of Dementia Care, Person-Centred Care, Personalisation, Quick Insights, Systematic Reviews
Tagged Advance Care Planning, ALOIS: the Cochrane Dementia and Cognitive Improvement Group, Assisted Feeding Treatments, Avoidable Hospital Admissions, Care Planning, Care Planning and Proxy Decision Making, Cochrane Database, Cochrane Database of Systematic Reviews, Death in Hospital, Decision-Making at End of Life, Easing Decision-Making, Ethics and Decision-Making, Feeding Assistance, Feeding Discussions, Home Palliative Care Services, Hospital Admissions, HRB Primary Care Clinical Trials Network Ireland, Ireland, NUI Galway, Palliative Care, Palliative Care in Advanced Dementia, Palliative Care in Older People With Dementia, Palliative Care Intervention, Palliative Care Planning, Palliative Care Teams, Palliative Care Teams in Acute Hospitals, Palliative Care Teams Versus Usual Care, Personalised Care Planning, Shared Decision-Making, Specialist Palliative Care Teams, Surrogate Decision-Making
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National Screening for Dementia Not Recommended (UK NSC / AHRQ / Annals of Internal Medicine / Epidemiology / International Journal of Epidemiology)
Summary The UK National Screening Committee (UK NSC) has upheld previous recommendations against screening people aged 65 and over for dementia. This decision follows an extensive review of the evidence. The UK NSC has concluded that tests for dementia, which … Continue reading
Posted in Acute Hospitals, Community Care, Department of Health, Diagnosis, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), Guidelines, Models of Dementia Care, National, NHS, Patient Care Pathway, Person-Centred Care, Practical Advice, Public Health England, Quick Insights, Standards, UK, Universal Interest
Tagged (Hepatocellular Carcinoma: Alphafetoprotein), Activities of Daily Living (ADL), Activities of Daily Living Scale, ADAS-Cog, ADAS-Cog: Alzheimer’s Disease Assessment Scale - Cognitive Subscale, Addenbrooke's Cognitive Examination (ACE), Addenbrooke's Cognitive Examination-Revised (ACE-R), Alzheimer's Disease Assessment Scale (ADAS-Cog11), Alzheimer’s Early Screening, Annals of Internal Medicine, Australia, Benefits of Detection and Early Intervention, Best Interest Decisions, Best Interests, Best Interests of Patients, Blackfriars Consensus Statement, Bond University, Brief Assessments, Cambridge Cognitive Examination (CAMCOG), CAMCOG-R: Cambridge Cognitive Examination-Revised, Case Finding, Case Finding for Patients with Dementia, Centre for Research in Evidence-Based Practice: Bond University, CERAD-NP, Clock Drawing Test, Clock Drawing Test (CDT), Cognition Disorders, Cognitive Assessment Tools, Cognitive Impairment, Complex Best Interests Decision Making, Consortium to Establish a Registry for Alzheimer’s Disease – NP (CERAD-NP), Counter-Intuitive Screening Evidence, Counterintuitive Screening Evidence, Dementia Case Finding, Dementia Case Finding Scheme, Dementia Challenge, Dementia Diagnosis, Dementia Screening, Dementia Screening Debate, DemTect, Department of Medicine: Stanford University School of Medicine, Department of Statistics: Stanford University School of Humanities and Sciences, Diagnosis and Referral, Diagnosis and Support, Diagnosis Gap, Diagnosis of Dementia, Diagnosis Rates, Difficult Conversations, Doctor-Patient Relationships, Dr Anne Mackie: Director of Programmes (UK NSC), Dr Charles Alessi: Dementia Lead for PHE, Early Diagnosis, Early Diagnosis of Alzheimer's Disease, Early Screening, Effectiveness of Early Detection and Treatment, Ethical Considerations, Ethical Dilemmas, Ethical Issues of Dementia Care, Ethics and Decision-Making, General Practice, GPs, Harms of Detection and Early Intervention or Treatment, Improving Diagnosis, Incentive Payments, International Journal of Epidemiology, International Journal of Geriatric Psychiatry, Mass Screening, MCI: Mild Cognitive Impairment, Memory Assessments, Mild Cognitive Impairment, Mild Cognitive Impairment (MCI), Montreal Cognitive Assessment (MoCA), Neuropsychological Tests, olutions for Public Health (SPH), Opinions About Meaning of Overdiagnosis: National Community Survey of Australians, PHE: Public Health England, Picture Based Assessments, Population Screening for Dementia Deyond Passive Case-Finding, Post-Diagnosis Support, Pre-Dementia (MCI), Prevalence of Cognitive Impairment, Primary Prevention Interventions, Prime Minister's Challenge on Dementia, Prime Minister’s Dementia Challenge, Progression of Mild Cognitive Impairment to Dementia, Quality Premium Payments, Recommendation against national dementia screening. London: Public Health England (PHE), Risk Assessment, Risk of Overdiagnosis Associated With Screening, Rowland Universal Dementia Assessment Scale (RUDAS), School of Public Health: University of Sydney, Screening, Screening for Cognitive Impairment, Screening for Cognitive Impairment in Older Adults, Screening for Dementia, Screening Programmes, Screening Tests, Screening: Counter-Intuitive Evidence, Screening: Counter-Intuitive Evidence (Abdominal Aortic Aneurysm), Screening: Counter-Intuitive Evidence (Abdominal Aortic Aneurysm: Ultrasound), Screening: Counter-Intuitive Evidence (Breast Cancer), Screening: Counter-Intuitive Evidence (Breast Cancer: Breast Self-Exam), Screening: Counter-Intuitive Evidence (Breast Cancer: Clinical Breast Exam), Screening: Counter-Intuitive Evidence (Breast Cancer: Mammography), Screening: Counter-Intuitive Evidence (Cardiovascular Disease), Screening: Counter-Intuitive Evidence (Cardiovascular Disease: Echocardiography), Screening: Counter-Intuitive Evidence (Cervical Cancer), Screening: Counter-Intuitive Evidence (Cervical Cancer: Cytology), Screening: Counter-Intuitive Evidence (Cervical Cancer: Human Papilloma Virus), Screening: Counter-Intuitive Evidence (Cervical Cancer: Visual Inspection), Screening: Counter-Intuitive Evidence (Colorectal Cancer), Screening: Counter-Intuitive Evidence (Colorectal Cancer: Faecal Occult Blood Test [FOBT]), Screening: Counter-Intuitive Evidence (Colorectal Cancer: Fecal Occult Blood Test [FOBT]), Screening: Counter-Intuitive Evidence (Colorectal Cancer: Flexible Sigmoidoscopy With or Without FOBT), Screening: Counter-Intuitive Evidence (Colorectal Cancer: Flexible Sigmoidoscopy), Screening: Counter-Intuitive Evidence (Colorectal Cancer: Single Flexible Sigmoidoscopy), Screening: Counter-Intuitive Evidence (Hepatocellular Carcinoma), Screening: Counter-Intuitive Evidence (Hepatocellular Carcinoma: Alphafetoprotein and Ultrasound), Screening: Counter-Intuitive Evidence (Lung Cancer), Screening: Counter-Intuitive Evidence (Lung Cancer: CA-125), Screening: Counter-Intuitive Evidence (Lung Cancer: Chest X-Ray), Screening: Counter-Intuitive Evidence (Lung Cancer: Chest X-Ray and Cytology), Screening: Counter-Intuitive Evidence (Lung Cancer: CT Scan), Screening: Counter-Intuitive Evidence (Multiple Flexible Sigmoidoscopy), Screening: Counter-Intuitive Evidence (Oral Cancer), Screening: Counter-Intuitive Evidence (Oral Cancer: Visual Exam), Screening: Counter-Intuitive Evidence (Ovarian Cancer), Screening: Counter-Intuitive Evidence (Ovarian Cancer: CA–125), Screening: Counter-Intuitive Evidence (Prostate Cancer), Screening: Counter-Intuitive Evidence (Prostate Cancer: Prostate-Specific-Antigen), Screening: Counter-Intuitive Evidence (Type 2 Diabetes), Screening: Counter-Intuitive Evidence (Type 2 Diabetes: Fasting Blood Glucose and HbA1c), Solutions for Public Health (SPH) Review, Stanford Prevention Research Center: Stanford University School of Medicine, Stanford University School of Medicine, Systematic Population Dementia Screening Programme: Not Recommended (UK NSC), Target Culture, Target-Driven Behaviour, Target-Driven Priorities, Targeted Screening, Timely Diagnosis, Trail Making Assessments, Trail Making Test, Trail Making Tests, Transition from Cognitive Impairment to Dementia, U.S. Preventive Services Task Force (USPSTF), UK National Screening Committee, UK National Screening Committee (UK NSC), United States Preventive Services Task Force, United States Preventive Services Task Force (USPSTF), University of Sydney, USA Department of Health Research and Policy, USA Department of Health Research and Policy: Stanford University School of Medicine, Verbal Fluency, Verbal Fluency Assessments
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Screening to Identify People at Risk of Dementia (JRCPE)
Summary This article in the Journal of the Royal College of Physicians of Edinburgh presents a balanced account of both sides of the argument with regards to whether screening for dementia might be beneficial, and concerning the recent controversy on … Continue reading
Posted in Acute Hospitals, Alzheimer's Society, Community Care, Diagnosis, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), National, Patient Care Pathway, Quick Insights, Scotland, UK, Universal Interest
Tagged Best Interest Decisions, Best Interests, Best Interests of Patients, Blood Pressure, Cardiovascular Risk, Cardiovascular Risk Factors and Cognitive Decline, Case Finding for Patients with Dementia, Cochrane-Registered Prevention Reviews, Complex Best Interests Decision Making, Conflicts of Interests, Continuum of Cognitive Impairment, Dementia Case Finding, Dementia Case Finding Scheme, Dementia Challenge, Dementia Diagnosis, Dementia Screening Debate, Diagnosis and Referral, Diagnosis and Support, Diagnosis of Dementia, Diagnosis Rates, Diagnosis Rates (Regional UK), Diet, Difficult Conversations, Doctor-Patient Relationships, Early Diagnosis, Early Diagnosis of Alzheimer's Disease, Early Screening, Ethical Considerations, Ethical Dilemmas, Ethical Issues of Dementia Care, Ethics and Decision-Making, Exercise, General Practice, GPs, Improving Diagnosis, Incentive Payments, Incentives, Journal of the Royal College of Physicians of Edinburgh, JRCPE: Journal of the Royal College of Physicians of Edinburgh, MCI: Mild Cognitive Impairment, Medical Ethics, Mild Cognitive Impairment (MCI), Misdiagnosis, Modifiable Risk Factors, Montreal Cognitive Assessment (MoCA), NAPC, National Association of Primary Care, National Association of Primary Care (NAPC), NHS Health Check, NHS Health Checks Programme, Norwich Medical School, Obesity, Over-Diagnosis, Perverse Incentives, Physical Activity, Physical Exercise, Post-Diagnosis Support, Post-Diagnostic Dementia Support, Post-Diagnostic Support, Potential Harms of Diagnosis, Pre-Dementia (MCI), Preventable Dementia (Public Health England), Preventative Care, Prevention, Preventive Care, Prime Minister's Challenge on Dementia, Prime Minister’s Dementia Challenge, Regular Exercise, Risk Factors, Screening, Screening for Dementia, Smoking, Target-Driven Priorities, Timely Diagnosis, University of East Anglia, Vascular Risk Factors, Vested Interests, Watling Medical Centre (UK), Western University: London Health Sciences Centre
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The Dementia Case-Finding Debate Continues (BBC News / BMJ)
Summary Fewer than half of the estimated 670,000 people with dementia typically receive a formal diagnosis, and the government has the well-intentioned aspiration to increase dementia diagnosis rates in England to two-thirds by 2015. A GP writing in the British … Continue reading
Posted in Alzheimer's Society, BBC News, Commissioning, Community Care, Diagnosis, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Social Workers (mostly), In the News, Integrated Care, Management of Condition, National, Patient Care Pathway, Person-Centred Care, Quick Insights, Standards, UK, Universal Interest
Tagged BBC Health News, Best Interest Decisions, Best Interests, Best Interests of Patients, Binscombe Medical Centre: Godalming [Surrey], BMJ, Breaking Bad News, British Medical Journal (BMJ), Case Finding for Patients with Dementia, Complex Best Interests Decision Making, Conflicts of Interests, Dementia Case Finding, Dementia Case Finding Scheme, Dementia Challenge, Dementia Diagnosis, Dementia Screening Debate, Diagnosis and Referral, Diagnosis and Support, Diagnosis Gap, Diagnosis of Dementia, Diagnosis Rates, Diagnosis Rates (Regional UK), Difficult Conversations, Doctor-Patient Relationships, Early Diagnosis, Early Diagnosis of Alzheimer's Disease, Early Screening, Ethical Considerations, Ethical Dilemmas, Ethical Issues of Dementia Care, Ethics and Decision-Making, Former Health Secretary Jeremy Hunt, General Practice, GPs, Health and Social Care Integration, Herefordshire Clinical Commissioning Group, Improving Diagnosis, Incentive Payments, Incentives, MCI: Mild Cognitive Impairment, Medical Ethics, Mild Cognitive Impairment (MCI), Misdiagnosis, NHS Herefordshire CCG, Over-Diagnosis, Perverse Incentives, Post-Diagnosis Support, Post-Diagnostic Dementia Support, Post-Diagnostic Support, Potential Harms of Diagnosis, Pre-Dementia (MCI), Prime Minister's Challenge on Dementia, Prime Minister’s Dementia Challenge, Quality Premium Payments, Screening, Screening for Dementia, Target Culture, Target-Driven Behaviour, Target-Driven Priorities, Timely Diagnosis
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NICE Drugs Policy and the Elderly (NHS Choices)
Summary News of a Department of Health consultation, which involves asking the National Institute for Health and Care Excellence (NICE) to consider “wider societal benefits” (in addition to the burden of illness and the impact a disease has on patients) … Continue reading
Posted in Department of Health, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Social Workers (mostly), In the News, Management of Condition, National, NHS, NHS Digital (Previously NHS Choices), NICE Guidelines, Non-Pharmacological Treatments, Pharmacological Treatments, Quick Insights, Standards, UK, Universal Interest
Tagged Age and Ageing, Age Discrimination, Age Equality, Ageing and Society, Ageing Policy in the UK, Ageing Population, Ageism, Behind the Headlines, Benefits from Treatments, Burden of Disease, Capacity to Benefit from Treatments, Cost Analysis, Cost-Effectiveness, Cost-Effectiveness in Health Care, Cost–Benefit Analyses, Daily Express, Daily Mail, Daily Telegraph, Disease Burden, Economic Contribution, Equality, Equality and Human Rights, Ethical Considerations, Ethics and Decision-Making, Ethics and Society, Everyone Counts, Health and Quality of Life, Justice, Moral Principles, National Institute for Health and Care Excellence (NICE), NHS Constitution, NICE Drugs Policy, Non-Maleficence and Beneficence, QALY, Quality of Life, Quality-Adjusted Life-Year (QALY), Respect for Autonomy, Societal Contribution, Value for Money, Value of Quality Adjusted Life Years (QALYs), Wider Societal Benefits, Wider Societal Burden, Wider Societal Costs
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Royal College of Nursing Consultation on Restraint in Health and Adult Social Care (RCN)
Summary The Royal College of Nursing (RCN) has been commissioned by the Department of Health to review and develop guidance on positive behaviour support (PBS) and the minimisation of restrictive practices across health and adult social care. The consultation closes … Continue reading
Posted in Acute Hospitals, Community Care, Department of Health, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Mental Health, National, NHS, Patient Care Pathway, Person-Centred Care, Practical Advice, Quick Insights, RCN, Standards, UK, Universal Interest
Tagged Abuse, Abuse of Vulnerable Adults, Acute Care, Adult Safeguarding, Adult Social Care, Attitudinal Change, Avoidable Harm, Behaviour Support Plans, Best Practice in PBS, Chemical Restraint, Culture of Zero-Harm, De-Escalation Techniques, Deprivation of Liberty Safeguards, Deprivation of Liberty Safeguards (DoLS), DoLS in Hospitals, East Kent Hospitals University NHS Foundation Trust, Ethical Considerations, Ethical Dilemmas, Ethics and Decision-Making, Harm Free Care, Least Restrictive Principle, MCA: Mental Capacity Act 2005, Mechanical Restraint, Medical Ethics, Mental Capacity, Mental Capacity Legislation, Northern Ireland, Openness and Transparency, Openness. Transparency, Physical Restraint, Physical Restraint in Hospital Settings, Physical Restraint in Mental Healthcare, Positive Behaviour Support (PBS), Proportionality in Safeguarding, Proportionality: Human Rights and Mental Capacity Legislation, Respect, Respecting Persons with Dementia, Responsible Commissioning, Restraint, Restraint in Health and Adult Social Care, Restrictive Practices, Royal College of Nursing (RCN), Safeguarding, Safeguarding Adults at Risk, Safeguarding Adults Principles, Safeguarding Older People, Scotland, Transforming Care, Transparency, Transparency and Accountability, Use of Reasonable Force, Wales, Winterbourne View Hospital
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Suicide Risk in Dementia Patients (Nursing Standard)
Summary Attempted suicide is not unknown among people with dementia but there is a lack of evidence to guide professional practice. This article explores risk management strategies and the ethics of suicide / assisted suicide by taking one specific patient … Continue reading
Posted in Acute Hospitals, Community Care, End of Life Care, For Carers (mostly), For Nurses and Therapists (mostly), For Social Workers (mostly), In the News, Management of Condition, Mental Health, Models of Dementia Care, Patient Care Pathway, Person-Centred Care, Practical Advice, Quick Insights, Scotland, Standards, UK, Universal Interest
Tagged Adult Support and Protection (Scotland) Act 2007, Advance Care Planning (ACP), Assisted Suicide, Assisted Suicide for Dementia, Autonomy and Choice, Breaking Bad News, Choice, Disclosure, Disclosure of Diagnosis, Dundee, Dundee College, Emotions (Upon Disclosure of Diagnosis, Ethical Considerations, Ethical Dilemmas, Ethical Issues of Dementia Care, Ethics and Decision-Making, Ethics and Society, Euthanasia, Euthanasia Versus Palliation, Fear (Upon Disclosure of Diagnosis, Five Wishes (Aging with Dignity 2013), Frustration (Upon Disclosure of Diagnosis, Loss (Upon Disclosure of Diagnosis, Mental Capacity Act 2005, Nursing Standard, Palliative and End of Life Care, Palliative Care, Patient Choice, Preferred Priorities for Care, Pro-Choice Campaign, Risk Management, Standards of Conduct Performance and Ethics for Nurses and Midwives (NMC 2008), Suicide, Suicide Risk in Dementia, Truth Telling, VIPS Framework of Dementia Care
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Two Sides of the Dementia Case-Finding Debate (BMJ)
Summary The UK government is introducing incentives for general practitioners to check for dementia in patients aged 75 and older, with the intention that timely diagnosis facilitates earlier support for patients with dementia. Critics of this policy allege that this … Continue reading
Posted in Acute Hospitals, Community Care, Diagnosis, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Models of Dementia Care, National, NHS, Patient Care Pathway, Quick Insights, Standards, UK, Universal Interest
Tagged BMJ, British Medical Journal (BMJ), Case Finding for Patients with Dementia, Commissioning for Quality and Innovation (CQUIN) Indicators, Dementia Case Finding, Dementia Case Finding Scheme, Dementia Commissioning for Quality and Innovation (CQUIN), Early Diagnosis, Early Diagnosis of Alzheimer's Disease, Early Screening, Ethical Issues of Dementia Care, Ethics and Decision-Making, General Practice, GPs, Head to Head Debates, Incident Dementia, Mandate to the NHS Commissioning Board, MCI, MCI: Mild Cognitive Impairment, Mental Health Care, National Dementia CQUIN, National Screening Committee, NHS Mandate, Prime Minister's Challenge on Dementia, Screening, Screening for Dementia, Timely Diagnosis, UK National Screening Committee
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