Development of a Pilot Specialist Dementia Nurse at a Tertiary Victorian Hospital

The pathway to a diagnosis of dementia and post-diagnostic support can be complicated for people living with dementia and their support networks, leading to delays in care. This paper describes the development and subsequent pilot of a specialist dementia nurse role named the Dementia Liaison Officer (DEMLO) within a tertiary Victorian hospital. The aim of the DEMLO was to identify and address gaps in dementia care. This pilot is based on the principles of the National Comprehensive Dementia Centre framework. Mapping of current outpatient diagnostic and post-diagnostic services for people with suspected cognitive impairment was conducted to identify gaps in care. Interviews with 25 hospital staff were also conducted to gain further perspectives on barriers to diagnostic and post-diagnostic care and inform the development of the DEMLO role. Several challenges to diagnostic/post-diagnostic support were identified, including the perception that waitlists were long, confusing referral criteria, and complex referral processes. The DEMLO was subsequently developed and trialled within the Geriatric Evaluation and Management (GEM) outpatient service. Three key functions were implemented: reviews of eligibility criteria for patients with cognitive impairment on the GEM clinic waitlist, introduction of a pre-clinic comprehensive geriatric assessment for GEM clinic patients and the introduction of a dementia post-diagnostic support service for all patients across the hospital. Challenges to developing and sustaining the pilot included limited timeframe, difficulty with integration and limited funding. Despite this, the pilot was well received, with 141 patients referred. The introduction of a nurse-led dementia intervention has resulted in increased person-centred care that encompasses pre-diagnostic and post-diagnostic support for people living with dementia. Evaluation of the pilot is ongoing.