Healthcare Staff
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We give an outline here of the various types of healthcare and social services staff you may come across, so you know what their roles are, and also what sort of services are available. These are the names used in the UK.
Doctor / GP (General Practitioner)
In the UK the GP is not only the person able to diagnose and prescribe treatments for most health problems but is also the primary point of contact for obtaining a 'referral' to one of the other healthcare professionals who concentrate on a particular specialist field.
Practice Nurse
A practice nurse works within a GP's practice office ('surgery'), performing simple procedures on behalf of the GPs, such as changing wound dressings and giving vaccinations.
District Nurse / Community Nurse
A district nurse performs the same tasks as a practice nurse, but travels to the homes of those unable to visit the GP's office.
Pharmacist
A qualified pharmacist is able to advise on medications. For example, they can answer questions about the medications the doctor has prescribed, and advise on non-prescription medications and their potential interactions with the prescribed medications. They may also be able to advise on other items, such as assistive aids.
It's important to note the distinction between a qualified pharmacist and other staff who work in a pharmacy shop or chemist's in a sales assistant role. If in doubt who it is then ask for the pharmacist.
They're a great resource, particularly because they're easily accessible. For non-urgent matters choose a less busy time of day to visit or phone, and we'd suggest using the pharmacy that dispenses your medication - partly because it may help that they already have the details and partly because after all they get the benefit of your custom. Alternatively, supermarket pharmacists may not be busy in the evenings if they remain open until late.
Community Psychiatric Nurse (PSN) / Community Mental Health Nurse
A community psychiatric nurse will be involved in assessing and monitoring cognitive impairment when dementia medications are prescribed. (For the sort of test they may use see our section on cognitive assessment.) They may be based at a 'memory clinic'.
Occupational Therapist (OT)
Occupational therapists can provide a range of help, to overcome problems associated with dementia and other conditions and to help recover abilities (for example after a stroke). They'll look at an individual's needs and circumstances, and can help to select assistive aids, demonstrate exercises for specific ailments, advise on improving the home environment to make things safer and easier, and so on.
In the UK, occupational therapists are available via the NHS (via your GP), via social services (via your county council or equivalent, see the NHS website's directory to find adult social care services) or privately for a fee (make sure you get a qualified one - see The Royal College of Occupational Therapists' website, or you can check on the Health & Care Professions Council website).
In the UK, NHS and council occupational therapists may be able to provide loan equipment for assistive aids.
Physiotherapist
Physiotherapists can determine the best approaches and exercises for your specific injury or ailment and for your particular case. This includes areas such as mobility problems with standing or walking, or recovery after a stroke. They can also provide therapeutic treatment by manually moving joints in order to aid recovery.
In the UK, physiotherapists are available via the NHS (usually via your GP), however there's generally a long wait which isn't helpful when this can lose the best opportunity for recovery rather than decline. Physiotherapists are also available privately for a fee (make sure you get a qualified one - see the Chartered Society of Physiotherapy's website, or you can check on the Health & Care Professions Council website).
Speech And Language Therapist (SALT or SLT)
Speech and language therapists deal with problems such as difficulty swallowing, which may cause coughing from drinking or eating, or other problems relating to eating or speaking. For swallowing difficulties they may direct that drinks should be thickened to a particular level using prescribed thickeners, or that food should have its texture modified by being mashed or pureed (see our section on thickened drink and textured/pureed food).
In the UK, speech and language therapists are available via the NHS (via your GP) or privately for a fee (make sure you get a qualified one - see the Association of Speech and Language Therapists in Independent Practice website, or you can check on the Health & Care Professions Council website).
Podiatrist / Chiropodist
A podiatrist (or chiropodist to use an older term) looks after feet, including cutting nails, treating various foot problems, and checking the health of those with diabetes.
In the UK, NHS podiatrists are usually only available (via your GP) under certain circumstances, such as having diabetes. Diabetics should receive periodic checks which are intended as a health check although they may also cut the nails 'while they're there'. However, these NHS visits won't be as frequent as the nails need cutting (which is about every 6 weeks).
A care or nursing home may have a visiting podiatrist, or they're also available privately for a fee, including ones who'll visit you in your own home (make sure you get a qualified one - in the UK see the NHS website's directory to find podiatrists and chiropodists, or you can check on the Health & Care Professions Council website).
Continence Nurse / Continence Adviser
A Continence Nurse or Adviser may be involved in the management of the condition, including identifying the most appropriate incontinence products.
In the UK, these services are available via the NHS (via your GP) and incontinence items can be prescribed, although owing to their high ongoing cost make sure you put forward a good case for pull-up incontinence pants if required owing to dementia, and for high absorbency. (These products are also available to buy online (but use a reputable supplier) and at many supermarkets.)
Dietician or qualified Nutritionist
A dietician or nutritionist can advise on problems such as weight loss (or gain) and with ensuring that the correct nutrition is obtained when there are difficulties with inadequate eating (for example due to poor appetite, excessive sleepiness or mouth discomfort).
There's a distinction to be made between dieticians and nutritionists, as follows.
'Dietitian' is a title that requires having qualifications, and these must also include the ability to take into account the needs of different medical conditions. 'Nutritionist' is a title that may be used without having qualifications, so you should only use a person who has qualifications (see below), and note that they still can't take into account specific medical conditions.
In the UK, dieticians and nutritionists are available via the NHS (via your GP), although there may need to be quite a significant weight loss before a referral, and there may be some wait. They're also available privately for a fee, but make sure you get a qualified one - see the Freelance Dieticians website or the Association for Nutrition website, under register - search, or you can check on the Health & Care Professions Council website.
In the UK, supplements for specific nutritional and energy needs can be prescribed on the NHS.
Dentist
It's extremely important to ensure good tooth care, particularly bearing in mind that a person with dementia may not be able to express clearly that they have toothache and where.
A care or nursing home may have a visiting dentist if dementia or a mobility issue makes visiting the dentist impractical, although it's much better to go to the dentist if possible, as they'll have a better level of equipment available there. If it's too far to go to your previous dentist, the home will probably be able to recommend one.
In the UK, dentists should be available on the NHS, but one with availability to take on new patients can be difficult to find - see the NHS website's directory for how to find an NHS dentist. NHS and private dentists can be found using the NHS website's directory for how to find a dentist.
In England, local dentists can also be found using the Care Quality Commission (CQC) website list of dentists, entering your postcode (and any other search filters you want). This lists the dental practices and enables you to read their inspection reports.
Having found a candidate dental practice you could then look at the practice's own website and see the length of experience of each dentist, perhaps aiming for one with reasonable experience but not one that's likely to retire soon. Bear in mind that if the practice is taking on new patients this may not be for all their dentists.
Optician or Optometrist
Technically the qualified person who tests your eyes is an optometrist, but they're widely called opticians after the shop they work in.
See our section on opticians and eye tests.
Social Worker
Social workers ensure that suitable care is found for those who need it, by arranging visiting carers at home or a place in a care or nursing home. They also check that the person's needs are being met.
In the UK social workers are also involved in periodic reviews under the Deprivation of Liberty Safeguards (DoLS), where someone's in a care or nursing home (or hospital) that has to lock the door to prevent people with dementia wandering out and getting into difficulty.
In the UK social workers are employed by the social services department of your county council or equivalent (see the NHS website's guide to adult social care services), or in some cases by NHS Trusts.