Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • presenting an immediate safety threat to oneself or others
  • suspected delirium considered unsafe to manage in the community determined by the treating medical practitioner
  • sudden and rapid onset of cognitive impairment with or without neurological symptoms.

Please contact the on-call registrar to discuss your concerns prior to referring.

For urgent referrals and/or clinical advice.

Dementia Support Australia Hotline

Central Adelaide Local Health Network 

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network


Exclusions

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • Aboriginal and/or Torres Strait Islander
  • rapidly progressive cognitive decline, over weeks
  • younger onset dementia

Category 2 (appointment clinically indicated within 90 days)

  • consideration of referral to memory trials
  • consideration of standard dementia therapy
  • dementia where confirmation of the sub-type and/or specialist input is needed
  • down syndrome and/or intellectual impairment with cognitive decline over minimum 6 months
  • genetically confirmed/strong family history of early-onset dementia
  • suspected dementia/cognitive impairment

Category 3 (appointment clinically indicated within 365 days)

  • nil

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • under the custody or guardianship of the Chief Executive
  • care-giver or third-party contact details, if patient consenting
  • advanced care directives status
  • age
  • past medical/surgical/psychosocial/psychiatric history
  • current medications and dosages, including:
  • allergies and sensitivities
  • use/ frequency of alcohol, tobacco, and other drugs
  • social situation
    • informal/family support and extent of support
    • safety concerns such as:
      • mobility
      • driving
      • home alone
      • compromised insight, if relevant
      • disorientation in public spaces
      • financial management
      • elder abuse
  • onset, duration, and changes/decline in:
    • cognitive impairment
    • behavioural changes/escalation
    • functional decline
    • unintentional weight loss
  • management history including:
    • treatments trialled/implemented prior to referral
    • existing formal and informal support services
    • allied health summaries and reports
    • National Disability Insurance Scheme (NDIS) / My Aged Care service providers
    • general practitioner management plan / health assessment
    • team care arrangement
    • mental health treatment plan
  • cognitive assessment, where appropriate
  • pathology
    • complete blood examination (CBE)
    • electrolytes and liver function tests (ELFTs)
    • calcium
    • thyroid stimulating hormone (TSH)
    • vitamin B12
    • mid-stream urine specimen (MSU) 
  • relevant diagnostic/imaging reports, including location of company and accession number

Additional information to assist triage categorisation

  • brain imaging - including location of company and accession number, if completed
    • computed tomography (CT) or
    • medical resonance imaging (MRI)
  • driver’s licence status
  • copy of advance care directives

Clinical management advice

Aboriginal and Torres Strait Islander populations may be at a higher risk of dementia and cognitive decline due to a range of factors, including higher rates of chronic health conditions, social determinants of health, and historical trauma. It is important to promote awareness, access to healthcare, and culturally appropriate support services that can help with early diagnosis, intervention, and management of dementia-related conditions. It's also crucial to take a holistic approach that considers both medical and social determinants of health when addressing these issues.

In the circumstance that severe behavioural disturbances do not meet the threshold for referral to Geriatric Medicine, please follow the Dementia Support Australia - Behaviour Support Process Flowchart to ensure appropriate management workflows are implemented.

People residing in high-level aged care facilities may be directed to Local Health Network (LHN) community in-reach teams for assessment at their residence where appropriate.

If polypharmacy, or drug interaction is suspected, consider referring for a home medicines review/residential medication management review.

Elderly patients may experience diminished appetite, dental issues, swallowing difficulties, and chronic medical conditions, all of which can contribute to malnutrition. Allied health professionals, including dietitians, speech pathologists, occupational therapists, and physiotherapists, are essential in assessing and managing these complexities. They collaborate to develop tailored nutrition plans, improve oral health, facilitate safe swallowing, improve safety barriers within the home, and enhance mobility, ultimately promoting better nutritional outcomes and overall quality of life. Allied health involvement should be considered in conjunction to referrals for specialist medical assessment.

Outpatient services are not meant to substitute for care and assistance available through other health programs that elderly patients might qualify for, such as services provided by My Aged Care or the National Disability Insurance Scheme (NDIS).

Clinical resources

Consumer resources

Reason for request

  • to establish a diagnosis
  • for treatment or intervention
  • for advice and management
  • for specialist to take over management
  • for a specified test/investigation the General Practitioner cannot order
  • for other reason (e.g. rapidly accelerating disease progression)
  • transfer of care from another tertiary service
  • clinical judgement indicates a referral for specialist review is necessary.

Patient demographic details

  • full name, including aliases
  • date of birth
  • residential and postal address
  • telephone contact number/s – home, mobile and alternative
  • Medicare number, where eligible
  • name of the parent or caregiver, if appropriate
  • preferred language and interpreter requirements
  • identifies as Aboriginal and/or Torres Strait Islander

Clinical modifiers

  • impact on employment
  • impact on education
  • impact on home
  • impact on activities of daily living
  • impact on ability to care for others
  • impact on personal frailty or safety
  • identifies as Aboriginal and/or Torres Strait Islander

Other relevant information

  • Willingness to have surgery, where surgery is a likely intervention.
  • Choice to be treated as a public or private patient.
  • Compensable status, e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.
  • Relevant social history, including identifying if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf.
  • Triage of a specialist outpatient referral is based on clinical decision making to allocate an appropriate urgency categorisation.
  • Where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
  • A change in patient circumstance (such as condition deteriorating or pregnancy) may affect the urgency categorisation and should be communicated as soon as possible.
  • All new referrals will be triaged by a consultant and appointment times scheduled according to clinical urgency.