GP annual review with a person with dementia

Understanding the diagnosis

The GP will check that the person with dementia understands their diagnosis. They may confirm which type of dementia they have, for example Alzheimer’s disease, vascular dementia or another type, and what this means.

Welfare questions

To make sure everyone is safe and well, the GP may check whether the person with dementia or their carer is at risk of harm, or of not looking after themselves properly.

They may ask whether there is anything causing them to feel stressed or uncomfortable. The GP might also ask about the person’s hobbies, interests or how they are managing daily activities.

They may ask what living well means to the person with dementia, and what support they need to continue to live well.

Contact details

The GP should check that the contact details of the person’s carer, family or friends are up-to-date. If you are a patient at the same GP practice, you should be offered a carer’s assessment and review of your own.

Treatments and support

At their annual review, the GP will talk to the person with dementia about how they can keep up their abilities and skills. For example, they might refer them to a physiotherapist to keep them mobile, or consider medication to help with changes in their behaviour.

Medication review

The GP may have already prescribed medication depending on what type of dementia the person has. There is no known cure for dementia, but medication can help with the symptoms.

If a specialist starts a course of medication, the GP will often take over responsibility for ongoing prescriptions of the drugs. This is once the person is taking the medication at the right dose for them.

If any drug appears to be having a side effect, contact the doctor straightaway. They may need to change the drug or the dose.

Part of the annual review is talking about any medication the person is taking for dementia or any other conditions they have (for example, high blood pressure). The GP will check they aren’t taking any unnecessary medication. 

If they recommend new medication, it can help to ask:

• what each drug is for and how it should help
• how and when it should be taken
• whether there are any side effects to watch out for.

Changes in behaviour

The GP may ask if there are any new symptoms since they last met, and how these are affecting the person and those supporting them. The GP may suggest treatment, or, if the symptom cannot be treated, they may discuss ways to manage it.

Experiencing changes

As dementia progresses, the person with dementia will experience changes and this might include behaving differently. This might cause them or their carer discomfort or challenges – for example, if they are agitated or restless.

The person may be distressed, or indicating a need they can’t communicate or may not even be aware of when they behave in this way. The GP should be able to rule out any physical causes, such as pain or an infection, that could be contributing to the behaviour.

Support for changes in behaviour

They may also offer information and support about their behaviour, or refer them on to a specialist service– for example, a community mental health team. This is a team of mental health professionals, such as social workers, community psychiatric nurses and occupational therapists, who work in the community to support people’s mental health.

Advance care planning

During the annual review, the GP may start or revisit discussions about advance care planning.

They may describe what could happen in the future, if the person no longer has capacity to make decisions about treatment and care – and particularly the following options.

Lasting power of attorney for England and Wales, or Enduring power of attorney for Northern Ireland 

Lasting power of attorneys (LPA) and Enduring power of attorneys (EPA) allow a person to appoint another person to make medical or financial decisions for them, for when they are no longer able to make those decisions themselves in the future.

Advance decisions for England and Wales, or directives for Northern Ireland

These legal documents allow a person to refuse, in advance, specific medical procedures or treatments. Like LPAs, advance decisions are legally binding. This means that health professionals have to follow these decisions if they can.

Advance statements

These allow a person to explain what they like and don’t like, and to set out their preferences for the future. Unlike LPAs and advance directives, advance statements aren’t legally binding, but they must still be taken into account.

End of life care

Thinking about care and end of life care can be distressing. It can also be reassuring to know that the person has done what they can to record their decisions and preferences in advance of the time when any decisions need to be made. It can allow them to then focus on living well.

Don’t be afraid to ask the GP about this subject. Being open and honest will help them to provide the best support for you and the person with dementia.

During the annual review, the GP might talk to you as the carer for the person with dementia. You have your own needs and you should feel supported too.

You have a right to a carer’s assessment, which is separate from the person with dementia’s needs assessment. For more information, see our information on Assessment for care and support in England, in Wales and in Northern Ireland.

The GP can let you know where you can access support such as local groups for carers. They should ask you if you want to register as a carer at the GP practice. See ‘Carers’ needs’ for more information.

Find out more including tips on maintaining your wellbeing as a carer, read Carers: looking after yourself.