Dementia 2018


Diagnosis & Management of Dementia in Primary Car

Welcome to this eLearning Programme on Diagnosis & Management of Dementia in Primary Care. This module provides current and practical information for GPs and other members of the Primary Care Team, addressing all aspects of dementia care - including diagnosis & management, the challenges posed by BPSD, and issues around sensitive legal issues, nursing homes and palliative care. Access to this eLearning is restricted to GPs and other health professionals, and the website requires registration. If you are a member of the public who has a query about Dementia, please contact your GP. Information is also available on the HSE's Understand Together website which can be accessed through this link: Understand Together 

Module Overview

External CPD Credits: 10
GMS Study Leave: 1 2/3 days                     
No. of Lessons: 10 
MCQ Assessment
Certificate of Completion


Welcome to this eLearning Programme on Diagnosis & Management of Dementia in Primary Care. 
This eLearning Programme is presented in 10 separate lessons, which follow the patient-journey from diagnosis, through advancing dementia, to palliative care. GPs have identified dementia as an area of learning need, and cited barriers to care which include - difficulties in making a diagnosis and around disclosure, problems with management of BPSD, and difficulty with legal and end-of-life matters. All of these issues are addressed in this eLearning Programme.
Each lesson comprises a video presentation conveying key learning points, and is approximately 10 minutes long to facilitate opportunistic learning. Additional videos including Expert Interviews and Clinical Scenarios are available in the Supplementary Resources section of each lesson, along with other supporting material - including useful links, practical advice & tools, patient or carer-centred material, and audit suggestions & guidance.
This eLearning Programme has been developed in partnership with the ICGP, the PREPARED dementia project, Department of General Practice UCC, and the ELEVATOR Dementia Project DCU. 
Funding for this elearning programme is from the PREPARED dementia project, Department of General Practice, UCC.  The PREPARED project is part of the National Dementia Strategy and is funded by the HSE and Atlantic Philanthropies.

Completion of this module will entitle you to 10 External CPD credits 


        There are 10 lessons as follows:

        Lesson 1: Prevalence, Aetiology & Prevention of Dementia

        This lesson outlines a symptom-based definition of dementia, explores common dementia subtypes, highlights risk reduction through modifiable risk factors, and considers the role of the GP in dementia care.

        Lesson 2: How to Make a Diagnosis of Dementia

        This lesson highlights the DSM diagnostic criteria for dementia, and the importance of making a timely diagnosis. A step-wise approach to diagnosing dementia is outlined which includes - history & collateral history, physical examination, medication review, appropriate investigations, and testing of cognitive function. Difficulties around disclosure are addressed in an accompanying supplementary video.

        Lesson 3: Post-Diagnosis Care & Review in Patients Living with Dementia

        The quality of care provided to patients living with dementia can be improved by focusing on key areas at regular intervals. This lesson provides a framework for review visits which includes - screening for depression, physical examination, review of medications, social care review, risk assessment, and review of the health & wellbeing of carers.

        Lesson 4: Involving Members of the Primary Care Team

        Each member of the Primary Care Team can bring a unique professional dimension to improving the quality of life of a person living with dementia, and GPs should consider involving other members of the primary care team in dementia management. This lesson focuses on the skills, approach, and added value, which each member of the team can bring to dementia care.

        Lesson 5: Medications in Dementia

        This lesson highlights the need for all medications used by people living with dementia to be reviewed regularly, and should include consideration of - current indication, continuing benefit, side-effects, potential interactions, and adherence. The use of Cholinesterase Inhibitors and Memantine is also discussed.

        Lesson 6: Behavioural & Psychological Symptoms of Dementia (BPSD)

        BPSD describes a collection of symptoms and behaviours experienced and displayed by patients living with dementia. Assessment is the corner-stone of management of BPSD and includes - out-ruling a physical cause (particularly delirium), and identifying unmet needs & potential triggers (including pain, medications, environmental & psychological factors). This lesson outlines non-pharmacological strategies for management for BPSD, and highlights the limited role of drug treatments. Concern over the safe use of antipsychotic medication is discussed in an accompanying supplementary video.

        Lesson 7: Legal Capacity, Enduring Power of Attorney, and Advance Healthcare Directives

        It is important that doctors understand the concept of capacity and are clear about what it entails. GPs have 3 main roles regarding legal matters in the context of patients with dementia - assessing testamentary capacity, assessing a patient's capacity to grant an enduring power of attorney (EPA), and understanding Advance Care Directives. GPs should also be aware of the implications of the Assisted Decision Making (Capacity) Act (2015), and of their responsibilities arising from it.

        Lesson 8: Determining Fitness to Drive in People Living with Dementia

        Making decisions regarding fitness to drive, or even raising the issue, can be challenging for GPs - however they have an obligation to provide clear advice to a driver where an illness or injury may increase the risk to themselves or others while driving. This lesson outlines RSA guidelines on fitness to drive in mild cognitive impairment (MCI) and dementia, discusses issues to consider when determining a patient's fitness to drive, highlights the value of input from occupational therapists and on-road driving assessors, and explains how to proceed when a decision has been made.

        Lesson 9: Nursing Home Care in Dementia

        In addition to medical management of their patients, GPs have a number of roles in dementia care in nursing homes including - medication monitoring & review , management of BPSD, cautious consideration of antipsychotic use & withdrawal, and end-of-life care. While most of these issues are also addressed elsewhere in this eLearning Programme, this lesson aims to tie together issues which arise for patients living with dementia in nursing home care.

        Lesson 10: Palliative Care in Patients Living with Dementia

        Palliative care services should be available to people with dementia in the same way they are available to people who do not have dementia. This lesson highlights the importance of timely referral to Palliative Care services.


The Medical Council has defined eight domains of good professional practice. These domains describe a framework of competencies applicable to all doctors across the continuum of professional development from formal medical education and training through to maintenance of professional competence. Since they describe the outcomes which doctors should strive to achieve, doctors should refer to these domains throughout the process of maintaining competence. In order to assist you in planning your professional competence, ICGP eLearning highlight the domains addressed in each module as set out below. 
NOTE: While a number of ICGP modules have a tight focus on one or two domains, most modules endeavour to address all domains to some degree (low, medium, high). This is clearly displayed in the diagram below

Useful Links

The HSE website 'Understanding Together' has many useful & practical resources addressing all aspects of dementia, and is aimed at members of the public[link ]

The website 'Dementia Pathways' contains many resources on dementia for health professionals [link ]

Last modified: Wednesday, 26 September 2018, 4:47 PM