Psychologists working in memory clinics

This section is for questions relating to therapy, assessment, formulation and other aspects of working with people in mental health services.

Post Reply
Prosopon
Posts: 90
Joined: Wed Nov 19, 2014 9:08 pm

Psychologists working in memory clinics

Post by Prosopon » Sun Dec 30, 2018 12:15 am

Hello, I was wondering if any Clinical Psychologists, trainees or Assistant Psychologists who work in a memory clinic could please give me an overview of what your job tends to involve? I currently work with people living with dementia and have become incredibly passionate about working in this area. Having just finished my psychology degree I am thinking about and exploring different career paths and I really want to learn more about what clinical psychologists actually do in the field of dementia, particularly when working in memory clinics.

I have researched memory clinics, of course, but information tends to be vague and I do not have a good sense of what exactly psychologists do and how this differs to staff from other disciplines (for example, do psychologists diagnose dementia, or is it just doctors who deal with diagnosis etc? Do psychologists continue to work with people after diagnosis, or is the focus primarily on diagnosing people, supporting people through the diagnosis process etc?)

Also, I have an interview coming up for an Assistant Psychologist role in a memory clinic and I really want to get a good understanding of the role of psychologists in this setting before my interview. I am trying to arrange an informal visit to the service to help with this, but it seems the main contact is on annual leave at the moment, and I'm not sure this will happen. Therefore I would be grateful for any information about working in this setting.
"Is this real? Or has this been happening inside my head?"

“Of course it is happening inside your head, Harry, but why on earth should that mean that it is not real?”

~From Harry Potter and the Deathly Hallows.

Advertisement
Pearson Clinical Assessment publishes a wide range of assessments to support psychology professionals including the Gold Standard Wechsler range. To view our range please visit: pearsonclinical.co.uk/cpf
lulabelle98
Posts: 23
Joined: Mon Feb 13, 2017 3:47 pm

Re: Psychologists working in memory clinics

Post by lulabelle98 » Wed Jan 02, 2019 11:44 am

Hey Prosopon,

I hope I can help. I've worked in two dementia-related services, and one learning disability service where my role focused on completing neuropsychological assessments to investigate memory concerns.

When I worked specifically in a memory service, the role was around completing neuropsychological assessments when the individual had been referred for memory concerns. By the time they were seeing me as an assistant, the individual had already been assessed originally by their GP, but also by a mental health nurse who would have completed the ACE-III (Addenbrooks Cognitive Examination; you can find this for free online). The person will have already had their bloods taken and hopefully a CT scan. All of this information, including the neuropsych results, would then go to the service's psychiatrist who made the diagnosis if there was one. However, there was so much more to the role than this. You can imagine how stressful this must be for people, to be assessed for something like a dementia. So part of my role was also to listen, to validate people's distress, to offer feedback appointments following an assessment. The service unfortunately didn't offer post diagnostic groups, but others do. There was a lot of signposting to other services too - be sure to know what charities there are in your area that can support someone, e.g. Alzheimer's Society. Meet with them too if you can. Then you had all the standard things like going to MDT meetings to feedback about your assessments or to receive referrals. I was only in this role for about 5 months before moving on to the next one (se below).

I worked in another dementia-related service, but more in the care home liaison side. I still did the odd neuropsych battery, but the role was more around supporting staff to understand people's distressed behaviour - look up the Newcastle model or the CLEAR model. This also involved a lot of staff training/reflective sessions. My supervisor worked across the memory service side as well as the care home liaison side. He often saw people who experienced more systemic difficulties, like family dynamics or the involvement of social service when trying to place someone. He offered staff in our service reflective practice sessions, and played a role in the development of the service as a whole. You could look up PIE/PIPE (psychologically informed environments).

Does any of this help? I'd be happy to answer any specific questions you may have. I suppose just bear in mind that all services will be different depending on the location and who is funding it!

Prosopon
Posts: 90
Joined: Wed Nov 19, 2014 9:08 pm

Re: Psychologists working in memory clinics

Post by Prosopon » Wed Jan 02, 2019 4:52 pm

Thank you so much for the information lulabelle98; this is really helpful. What neuropsychological assessments would you use? Also, what would the feedback appointments involve? Would this be to tell people the diagnosis or would the doctor do that?
"Is this real? Or has this been happening inside my head?"

“Of course it is happening inside your head, Harry, but why on earth should that mean that it is not real?”

~From Harry Potter and the Deathly Hallows.

lulabelle98
Posts: 23
Joined: Mon Feb 13, 2017 3:47 pm

Re: Psychologists working in memory clinics

Post by lulabelle98 » Thu Jan 03, 2019 12:45 pm

Sent you an email :)

User avatar
stephenkingfan
Posts: 45
Joined: Wed Jun 19, 2013 8:41 pm

Re: Psychologists working in memory clinics

Post by stephenkingfan » Sun Feb 17, 2019 8:50 pm

Hello,

Sorry this is so late, but hopefully may still be of use to you and others wondering about the role of psychology in the memory clinic. I am currently a second year trainee on placement in a memory clinic for older adults. I've been there 2 days a week since November, so still fairly early on.

My experience is similar to the first service described by lulabelle98. I would say that usually a GP refers a person, they are then seen by a nurse who takes a history of the current difficulties and does the ACE III. This is often fed back to MDT meetings, and if there is a concern about dementia, the person is booked in to see one of our psychiatrists who potentially makes the diagnosis (or alternatively the person might be discharged if the nurse assessment suggests no memory problem as a result of dementia). As described by lulabelle98, bloods and a CT scan will hopefully have been done to rule out any other potential causes of memory problems and to rule in a possible dementia.

If the picture is very complex and the nurse/psychiatrist are unsure if a dementia is likely, a referral to psychology is usually made. In this case the person attends a neuropsychology appointment (usually with a family member) and we do a 2 hour assessment appointment. In this appointment we do a detailed history of the presenting problem to include areas of memory, language, visuospatial, attention and fluency, but also to gain a picture of how the problem is impacting on the person in their daily life. We also ask the family member/carer their perspective on the situation. We then do around an hour of cognitive testing; the tests will vary according the the referral, what we think we are looking for (i.e. was a certain type of dementia indicated from the previous assessments/referral), and according to the specific needs of the person.

Following this, we feedback in the appointment if we think there is a possible dementia. We don't diagnose and so we can't say for certain, but we would indicate that we think they need to come in and see the psychiatrist. At the psychiatrist appointment, psychology attend to, and all the info gathered is pulled together and the psychiatrist comes to a conclusion.

I am aware of other memory services in nearby areas that operate a different model, in that a person sees a nurse/assistant psychologist and the psychiatrist all in the same day, so they might be there for several hours, but everything is done in 'one go' where possible, whereas the service I work in, someone might end up having 3-4 appointments.

Hope that helps :)

User avatar
stephenkingfan
Posts: 45
Joined: Wed Jun 19, 2013 8:41 pm

Re: Psychologists working in memory clinics

Post by stephenkingfan » Sun Feb 17, 2019 9:17 pm

I just thought to add; the psychology team don't tend to do any follow up. We do the one-off assessments, attend the joint appointments with psychiatry to feedback our assessment, and that's it. Might be different in other services though?

Post Reply

Who is online

Users browsing this forum: No registered users and 1 guest