A Guide to

Memory Clinics
in Ireland
4th edition

Updated by Matthew Gibb, Dementia Services Information

and Development Centre and Dr Emer Begley,
National Dementia Office
Contents:
Introduction........................................................................................................................4

What is a Memory Clinic? ..............................................................................................5

Numbers and locations of Irish Memory Clinics ...................................................5

How to access Memory Clinic services ....................................................................6

What information will be asked of clients and their

family members at a Memory Clinic assessment?................................................6

Do all people who attend a Memory Clinic receive a diagnosis? ...................7

At Memory Clinics, what information is given to people worried

about their memory and to those diagnosed with Mild Cognitive
Impairment or dementia?..............................................................................................7

What treatments and services are offered at Memory Clinics? .......................8

Do Memory Clinics charge patients for their services? ......................................8

Does attending a Memory Clinic mean being admitted to hospital?............8

Memory Clinics in Ireland........................................................................................9-35

Location of Memory Clinics in Ireland ....................................................................36

Summary ...........................................................................................................................37

References ........................................................................................................................39

Acknowledgements ......................................................................................................40

Authors ..............................................................................................................................40

Useful Websites ...............................................................................................................41

 Introduction

Since this booklet was first published in 2010 both the interest and concern about
Alzheimer's disease and related dementias has grown from relative obscurity to
their becoming the biggest challenge to global health and social care. Countries
are now being forced to take these conditions seriously and over the last few years
we have witnessed some significant developments. This includes the World Health
Organisation declaring dementia a public health priority in 2012; the G8 group of
leading countries convening a summit in London and setting the ambitious target
of identifying a cure, or a disease-modifying therapy, for dementia by 2025 and at
least 18 of the 28 EU member states having in place some form of dementia
strategy or plan.

In 2014, Ireland developed its own national dementia strategy and as with many
of our European neighbours, the strategy highlights the role that memory clinics
have, both in the diagnosing and the sub-typing of conditions. The strategy also
calls for the 'timely' diagnoses of dementia through the identification of memory
clinics, the clarification of referral pathways, the use of common referral templates
and appropriate triage of referrals. This booklet was first developed to provide
much needed information about memory clinic services around the country to
health service professionals, family members and individuals concerned about
their memory or cognition. Its purpose remains much the same today. New services
have developed and some, sadly, have been forced to close. Most, if not all, of
Ireland's public memory clinic services have been developed within existing
resources and are therefore reliant on the hard work and commitment of their staff.

4
What is a Memory Clinic?
Memory clinics were first described in the US in the 1980's and the first clinic
opened in Ireland in 1991. Their purpose is the "identification, investigation and
treatment of memory disorders including dementia" (Jolley et al, 2006).

In Ireland, there is a lack of uniformity in the services that they provide and the
specialisms of the health professionals involved and so memory clinics can vary
widely in both their composition and the type of services provided. All would strive
to make timely diagnoses and provide treatment where appropriate and they
would also aim to identify and treat health problems other than dementia that
may be causing the client difficulties. Memory clinics also play an important role
in reassuring those who are worried about their memory when there are no
problems to be found.

The timely diagnosis of a dementia allows not only for appropriate treatments to
commence, but also provides an opportunity to offer important information and
advice on a range of issues such as financial and legal affairs, to accessing support
services. It also enables the person experiencing symptoms to be more proactive
in lifestyle decision-making and planning his or her own future care. Memory clinics
may also provide post-diagnostic counselling and emotional support for people
newly diagnosed. Some clinics offer the opportunity to become involved in
research such as drug trials and lifestyle intervention studies.

Numbers and locations of Irish Memory Clinics

There are currently 25 memory clinics in Ireland. The clinics are not positioned
according to geography or by population, indeed over 50% of counties do not have
a memory clinic. A recent review project (Fagan, 2017) found that there are
memory clinics in 13 counties but none in Donegal, Sligo, Leitrim, Cavan,
Monaghan, Galway, Mayo, Clare, Louth, Longford, Kerry, Waterford and Wicklow.
A third of all memory clinics are based in Dublin while there are none at all in the
Northwest which has the highest prevalence rates of people living with dementia
in Ireland. This inequality of access to memory clinics has led to calls for specialist
memory clinics to be established throughout the country. Ideally the memory
clinics would be multidisciplinary and have access to adequate resources.

5
 How to access Memory Clinic services
Anyone can avail of a Memory Clinic service. However, most clinics only accept
referrals from GPs or other medical doctors. Therefore, if you believe that your
memory is not as sharp as before and if you are worried about this, you should
discuss the matter with your GP. Your GP will assess the situation and may refer
you to a Memory Clinic if that is necessary. Most Memory Clinics cater to people of
all ages and many will also assess people with an intellectual disability.

What information will be asked of clients and their family members

at a Memory Clinic assessment?
When an appointment for a Memory Clinic is made, people are usually asked to
have a family member or close friend accompany them. The reason for this is that
the latter can, if necessary, provide staff with additional information regarding the
person’s memory, cognitive problems and overall health. During the clinic
appointment, the person experiencing the problems will be asked a series of
questions; where appropriate, additional questions will be asked of the family
member or close friend.

Information usually sought includes questions about the person’s general health;
the nature of the memory problems and when they started; risk factors for
Alzheimer’s disease and other dementias such as family history, smoking, obesity,
diabetes, and hypertension.

Additional information that might be useful may also be collected including

behavioural/personality changes, educational attainment and literacy level,
physical functioning and activities of daily living. A neuropsychological assessment
may also take place which usually involves a series of questions assessing short-
term and long-term memory, language, orientation, attention, perception and
calculation. The latter can be brief or may be more in-depth.

6
Do all people who attend a Memory Clinic receive a diagnosis?
Generally, everybody who attends a Memory Clinic receives feedback on the results
of the formal assessment. Results may suggest a number of things. For example,
they could show that a person has a subjective memory complaint or that they
have a mild cognitive impairment (a problem with memory or cognition that is not
normal for one's age and education) or they could indicate that the person has a
dementia.

If a clinical diagnosis is established, this will be discussed with the person in

accordance with his/her wishes. It is generally recommended that clinic staff
discuss the diagnosis with the person, unless there are clear reasons against doing
this.

At Memory Clinics, what information is given to people worried

about their memory and to those diagnosed with MCI or dementia?

Extensive information is provided to people who attend Memory Clinics.

The type of information provided typically includes:

l Ways to improve and maintain cognitive/brain health

l Lifestyle advice

l Clarification of memory problem symptoms

l Diagnosis, including differential diagnosis

l General tips for dealing with memory problems

l Treatment information such as advice about anti-dementia drugs and how

they work

l Advice about continuing or not continuing to drive

l Advice about continuing or not continuing to work

l Leisure time activities

7
 What treatments and services are offered at Memory Clinics?
Treatments and services offered at Memory Clinics vary and ideally they should be
tailored to the needs of each individual. The available drug treatments can be
effective in the short-term and may help to stabilise the condition for a period of
time but it needs to be remembered that the drugs are not curative and do not
tackle the underlying cause of the condition. These drugs can have modest benefits
but unfortunately not everybody will benefit from them.

Other interventions that do not involve medications might also be offered through
Memory Clinic services. Such interventions include information, counselling and
advice on practical everyday aids designed to help improve quality of life. Some
services may offer interventions such as Cognitive Stimulation Therapy or cognitive
rehabilitation.

Do Memory Clinics charge patients for their services?

Most Memory Clinics are funded through the HSE and will provide services free of
charge. However, in some instances there may be some “out of pocket costs”
incurred by patients for CT or MRI scans. Four of the Memory Clinics in this booklet
are privately run. In these circumstances some service costs may be recouped
through health insurance schemes.

Does attending a Memory Clinic mean being admitted to hospital?

People should be reassured that most Memory Clinics are outpatient services and
do not generally involve hospital admission. One exception is the Memory Clinic
at St Patrick’s Hospital, which is private and offers both in-patient and outpatient
assessment services. There, the average length of stay for assessment is two days
and the cost of in-patient services is covered by private health insurance.

8
 1

CoNNACHt
Memory Clinic, Roscommon Hospital,
Roscommon
Location and Contact: Memory Clinic, Roscommon Hospital, Athlone Rd,
Roscommon Tel: 090 663 2206

Profile: Diagnosis of dementia with nine month follow-up if stable. More

frequent if not. Referral to Community Dementia Liaison Nurse. Refer to St
James’s Hospital, Dublin if early onset or atypical case

Catchment area: Roscommon and East Galway

Frequency: Three times per month

Referral: GPs, Consultants and Public Health Nurses

Funding: HSE

Costs: No costs to patients

Post-diagnostic support: Community Dementia Liaison Nurse

Staff: 1 x Consultant Geriatrician, 1 x Clinical Nurse Specialist in Geriatric

Medicine, 1 x Intern

Services available to people under 65: Yes

Services available to people with intellectual disabilities: Yes

9
 2

DubLIN LeINSteR
bloomfield Hospital Memory Clinic, Dublin
Location and Contact: Bloomfield Hospital, Stocking Lane, Rathfarnham,
Dublin 16 Tel: 01 495 6800
Profile: The Bloomfield Memory Clinic is a multi-disciplinary, consultant-
led service providing assessment, diagnosis and support to those
presenting with memory or neurocognitive difficulties in adults aged over
18 including those with learning difficulties. Full consultation entails three
separate outpatient visits to the clinic for initial interview, full
neuropsychological assessment and feedback of results and treatment plan

Catchment area: Nationwide

Frequency: 1-2 times per week

Referral: GPs and other medical professionals

Funding: Bloomfield is a not-for-profit charitable organisation owned by

the Society of Friends (Quakers)

Costs: There is a set cost for each assessment, which consists of three
outpatient appointments. Most scans will be covered by private insurers

Post-diagnostic support: Post-diagnostic support services including:

counselling, peer support, referral to day centre and caregiver support
services (including Alzheimer and Huntington’s disease cafés and specific
caregiver workshops). Follow up consultations are available as needed

Staff: 2 x Consultant Old Age Psychiatrists, 1 x Senior Neuropsychologist,

members of Nursing, Occupational Therapy, Pharmacy or Social Work
services assess as required

Services available to people under 65: Yes

Services available to people with intellectual disabilities: Yes

10
 3

Memory Assessment and Support Clinic,

Connolly Hospital, Dublin
Location and Contact: Holly Day Ward, Blanchardstown, Dublin 15
Tel: 01 646 5557

Profile: To assess and outrule/diagnose dementia and offer supports post

diagnosis. To link with community services to ensure appropriate support
for people with dementia and their families

Catchment area: Connolly Hospital catchment area

Frequency: Twice weekly

Referral: GP, Multidisciplinary teams, other hospital teams, Community

teams where appropriate

Funding: HSE

Costs: No costs to patients

Post-diagnostic support: Patient support clinic, carer support clinic,

dementia nurse specialist as point of contact, virtual support clinic

Staff: Consultant Geriatrician, Dementia Nurse Specialist, Medicine for the

Elderly Registrar, Case Manager for Older People as needed, Multi-
disciplinary team as needed

Services available to people under 65: Yes. Limited service. Generally on

a case by case basis following discussion with the GP/referrer

Services available to people with intellectual disabilities: Yes. Limited

service. Generally on a case by case basis following discussion with the
GP/referrer

11
 4

Memory Clinic, St Columcille's Hospital,

Loughlinstown, Co. Dublin
Location and Contact: Memory Clinic, St Columcille's Hospital,
Loughlinstown, Co. Dublin Tel: 01 282 5800
Profile: To assess, investigate and diagnose people with memory or
cognitive difficulties. To commence a treatment and management plan if
required to include referral for memory and or cognitive communication
rehabilitation
Catchment area: Parts of south Co. Dublin and north Co. Wicklow
Frequency: Currently one clinic a month but looking to increase this due
to high demand
Referral: GP, medical teams and allied health professionals
Funding: HSE
Costs: No costs to the patient
Post-diagnostic support: An Occupational Therapist led Memory
Rehabilitation programme that includes one session with a Social Worker. This
is a 4 week course for people diagnosed with mild to moderate dementia. A
Speech and Language Therapist led cognitive communication rehabilitation
programme (six week course). There is a dementia friendly home
incorporating a resource room where patients and carer’s can view equipment
that will enable people with dementia to live at home. Referral to Alzheimer’s
Café in Bray which is jointly run by the hospital's allied health professional and
nursing staff, members of the community and the Alzheimer’s Society.
Referral to Alzheimer’s Society and Wicklow Dementia Society
Staff: 1 x Consultant, 1 x Specialist Registrar, 1 x Registrar/SHO Plus access
to Occupational Therapists, Speech and Language Therapists and other
allied health professionals
Services available to people under 65: No. People under the age of 65 are
referred to the Neurology service at St Vincent's University Hospital
Services available to people with intellectual disabilities: If over the age of 65

12
 5

the Dementia Advisory Resource Centre,

Daughters of Charity Service,
St Joseph's Centre, Clonsilla, Dublin
Location and Contact: The Dementia Advisory Resource Centre, Daughters
of Charity Service, St Joseph's Centre, Clonsilla, Dublin Tel: (01) 824 8658/8662
Email: evelyn.reilly@docservice.ie or pamela.dunne@docservice.ie
Profile: This specialist Memory Clinic provides baseline screening, dementia
assessment and comprehensive diagnostic work up for persons with an
intellectual disability (ID). A multi-disciplinary team works together and will
form a consensus diagnosis and recommend pharmacological and
psychosocial interventions as deemed appropriate to each individual. In
addition a dementia education programme is offered to staff, families and
peers. Nurse led with a strong multi-disciplinary element
Catchment area: The Daughters of Charity Services, Dublin, Roscrea and
Limerick
Frequency: Monday to Friday
Referral: Psychiatry/ Psychology or Physicians at the Daughters of Charity
Service. Limited referrals are also accepted from other Intellectual Disability
and generic services
Funding: HSE
Costs: No cost to patients; possible charge for some scans and consultancy
Post-diagnostic support: Day Service, Respite support, Palliative and End
of Life Care, and staff, family and peer education
Staff: 1 x Policy and Service Advisor, 2 x full time Clinical Nurse Specialists
in Dementia. In addition, Consultant Psychiatrist, Physician, Psychologist,
Physiotherapist, Occupational Therapist, Speech and Language Therapist,
Social Worker, Dietician are all available on a sessional basis
Services available to people under 65: Yes
Services available to people with intellectual disabilities: Yes

13
 6

Highfield Healthcare, Memory Clinic,

Co. Dublin
Location and Contact: Highfield Healthcare Memory Clinic, Swords Road,
Whitehall, Co. Dublin Tel: 01 837 4444

Profile: A consultant-led memory assessment clinic for early diagnosis of

dementia

Catchment area: Nationwide

Frequency: Monday to Friday

Referral: Mainly from GPs

Funding: Private

Costs: There is a set cost for initial assessment. Neuropsychology can be

provided on an out-patient or in-patient basis

Post-diagnostic support: Social Work and Occupational Therapy, a liaison

nurse provides services to community-dwelling patients

Staff: Old Age Psychiatrist, Neuropsychologist, Social Worker

Services available to people under 65: Yes

Services available to people with intellectual disabilities: Yes

14
 7

Mater Hospital Memory Clinic, Dublin

Location and Contact: Medicine for the Elderly Day Hospital, Mater
Misercordiae University Hospital, Eccles Street, Dublin 7 Tel: 01 803 4242

Profile: The Mater Memory Clinic is a consultant-led service offering

diagnosis, information and advice on dementia for both the patient and
family members

Catchment area: North Dublin

Frequency: Once weekly

Referral: GPs, medical and surgical specialists within the hospital

Funding: HSE

Costs: No costs to patients

Post-diagnostic support: There is access to Health and Social Care

Professionals to include, but not limited to, Social Worker, Neuropsychology
and referrals onwards to health and social care services in both primary and
community partners

Staff: There are no dedicated staff for the memory clinic. Staff provide
support for this and other clinics as part of the Day Hospital. The current
staffing excluding the medical staff is: 3 x administration staff, 1 x Clinical
Nurse Manager (II), 1 x Clinical Nurse Manager (I), 1 x Staff Nurse

Services available to people under 65: Yes

Services available to people with intellectual disabilities: Yes

15
 8

Mercer's Memory Clinic,

St James's Hospital, Dublin
Location and Contact: MISA Building, St James's Hospital, James's Street,
Dublin 8 Tel: 01 416 2640

Profile: The Mercer's Memory Clinic is the only national, full-time,

specialised service for people with memory and/or cognition problems. It
provides access to complex neuroimaging, neuropsychological testing and
cerebral spinal fluid biomarker testing where appropriate. It aims to provide
an accurate and timely diagnosis for it's clients and offers detailed advice
and information on brain health and living well

Catchment area: Nationwide

Frequency: Five days per week

Referral: Medical doctor

Funding: HSE

Costs: No costs to patients

Post-diagnostic support: Cognitive Rehabilitation group. Post diagnostic

advice and support including signposting to community resources. Family
meetings on request. All provided from existing resources within the
Memory Clinic

Staff: 1 x Medical Director Consultant Psychiatrist (.2 WTE*), 1 x Consultant

Geriatrician (.1 WTE), 1 x Geriatric Registrar (.5 WTE), 1 x Psychiatric Registrar
(.5 WTE), 1 x Geriatric registrar or Specialist Registrar (.2 WTE), 1 x
Neuropsychologist (.8 WTE), 1 x Neuropsychologist (.2 WTE), 1 x Clinical
Nurse Manager (FT**), 1 x Administrator (FT), 1 x Social Worker (.5 WTE)

Services available to people under 65: Yes

Services available to people with intellectual disabilities: Yes

* WTE - whole time equivalent ** FT - full time

16
 9

St John of God Memory Assessment Service,

Co. Dublin
Location and Contact: St John of God Hospital, Stillorgan, Co. Dublin
Tel: 01 277 1400

Profile: The function of the Memory Clinic is to provide full psychiatric

assessment for those who have concerns regarding memory. It also provides
neuropsychological and functional assessment

Catchment area: Nationwide

Frequency: One day per week

Referral: GPs and Consultants

Funding: Private

Costs: On application

Post-diagnostic support: Pharmacological and non-pharmacological

management, local carer support group available

Staff: 2 x Consultant Psychiatrists, 1 x Senior Clinical Psychologist, 1 x Senior

Occupational Therapist, Secretarial support

Services available to people under 65: Yes

Services available to people with intellectual disabilities: No

17
 10

Memory Assessment and Support Clinic,

St Mary’s Day Hospital, Dublin
Location and Contact: St Mary’s Day Hospital, Phoenix Park, Dublin 20
Tel: 01 625 0544

Profile: To provide an initial assessment and to provide support to the

person and to their family

Catchment area: Dublin north city

Frequency: One morning every second week

Referral: GP

Funding: HSE

Costs: No cost to patient

Post-diagnostic support: Carers support group. Occupational therapist

does care planning, guidance and education for the family/carers

Staff: Consultant-led. 2 x Geriatrician, 1 x Clinical Nurse Manager,

1 x Occupational Therapist. Physiotherapist as required

Services available to people under 65: No

Services available to people with intellectual disabilities: Yes if over 65

18
 11

Multidisciplinary Memory Clinic,

St Patrick’s Mental Health Services, Dublin
Location and Contact: Multidisciplinary Memory Clinic, St Patrick’s Mental
Health Services, James’s Street, Dublin 8 Tel : 01 249 3437

Profile: The Memory Clinic offers a comprehensive diagnostic assessment

of service users who present with a range of memory and cognitive
difficulties. The purpose is to accurately define, describe and diagnose any
underlying clinical conditions, as well as to compile a detailed plan of
management to remit the difficulties

Catchment area: Nationwide

Frequency: Weekly

Referral: General Practitioners, Psychiatrists (internal and external to

SPMHS), Neurologists, Geriatricians and other specialists

Funding: Privately funded through private insurers. Self-funding possible

Costs: Initial outpatient assessment in the Dean Clinic is free of charge but
a refundable deposit is required. The two-day inpatient assessment is
funded by private Health Insurers

Post-diagnostic support: Individual and family post-diagnostic support

available as required. Referral to external agencies is incorporated into
management plan

Staff: 1 x Consultant Psychiatrist, 1 x neuropsychologist

Services available to people under 65: Yes

Services available to people with intellectual disabilities: No

19
 12

Memory Clinic, Carew House,

St Vincent's university Hospital, Dublin

Location and Contact: Memory Clinic, Carew House, St Vincent's University

Hospital, Dublin Tel: 01 221 3758

Profile: We will see patients over 65 years old with undiagnosed

memory/cognitive difficulties who appear to be functioning well with an
MMSE over 23 (query Mild Cognitive Impairment). These patients will be
followed up

Catchment area: South East Dublin / East Wicklow

Frequency: Three Monday afternoons a month

Referral: GPs, allied health professionals

Funding: HSE

Costs: No cost to patient

Post-diagnostic support: Occupational therapist with a specialist interest

in cognitive disorders reviews patient and discusses/advises on memory
aids/adaptations. Patients are recommended to contact the Alzheimer
Society and information on local Alzheimer cafés is given

Staff: 2 x Consultant in Geriatric Medicine & 1 x Clinical Nurse Specialist

(CNS)

Services available to people under 65: No. People under the age of 65 are
referred to the neurology service

Services available to people with intellectual disabilities: Yes if over 65

20
 13

Memory Assessment Clinic,

tallaght Hospital, Dublin 24
Location and Contact: Memory Assessment Clinic, Department of Age-
related Healthcare, Tallaght Hospital, Dublin 24 Tel: 01 414 2498
Fax: 01 414 3244

Profile: Multidisciplinary comprehensive assessment and timely diagnosis

of memory complaints. Post diagnostic support and information

Catchment area: Nationwide

Frequency: Twice weekly

Referral: GPs and Consultants

Funding: HSE

Costs: No cost to patients

Post-diagnostic support: Informal links with Alzheimer Society of Ireland

support services. Post-diagnostic counselling when necessary

Staff: 5 x Consultant, 1 x specialist registrar, 2 x Clinical nurse specialists,

1 x Occupational Therapist; 1 x Clinical nutritionist, 1 x Speech and Language
Therapist, 2 x Clinical psychologists; 1 x Clinical trials coordinator

Services available to people under 65: Limited service, generally on a

case-by case discussion with GP/referrer

Services available to people with intellectual disabilities: Limited

service, generally on a case-by case discussion with GP/referrer

21
 14

LeINSteR
Memory Clinic, Sacred Heart Hospital, Carlow
Location and Contact: Memory Clinic, Day Hospital, Sacred Heart Hospital,
Old Dublin Road, Carlow Tel: 059 913 6492 or 059 913 6300

Profile: Consultant diagnostic service within a Geriatric outpatient service

with a Memory Clinic focusing on post-diagnostic care support,
maintenance and management. Monitor and review any further
deterioration in condition since last appointment, carry out an MMSE and
liaise with family members as required

Catchment area: Carlow

Frequency: Every two weeks

Referral: Geriatrician

Funding: HSE

Costs: No cost to patients

Post-diagnostic support: Carer support group meet once a month

Staff: 1 x Clinical Nurse Manager, 1 x Occupational Therapist

Services available to people under 65: Yes

Services available to people with intellectual disabilities: Yes

22
 15

Memory Clinic (Intellectual Disability),

St John of God Community Services Ltd.,
Liffey Region Kildare Services, Co. Kildare
Location and Contact: Memory Clinic (Intellectual Disability), St John of
God Community Services Ltd., Liffey Region Kildare Services, Celbridge,
Co. Kildare

Profile: The Memory Clinic provides an assessment and consultation service

for adult service users with intellectual disabilities and their families and
carers. In line with best practice guidelines, there is an emphasis on the
proactive assessment of adults with Down syndrome, given the high risk of
dementia in this population

Catchment area: Memory Clinic services are provided to St John of God

Liffey Region residential and/or day service users only

Frequency: The Memory Clinic meets once a month to discuss cases, with
a focus on consensus diagnosis and recommending treatment and
supports, and to process new referrals. Additional case conferences and
meetings with service users and their carers are scheduled on other days,
as needed, with the participation of members of the Memory Clinic.
Assessments are conducted by relevant members of the team, outside of
the meetings above, based on demand for assessments and clinician
availability. Memory Clinic duties form a component of each member’s
larger role within the service

Referral: Referrals are usually made on behalf of service users by frontline

staff teams/supervisors within the service

Funding: St John of Gods

Costs: No cost to patients

23
 Post-diagnostic support: Available post-diagnostic supports include
access to the St. John of God Liffey Services multi-disciplinary team
meetings (Psychology, Psychiatry, Social Work, Speech and Language
Therapist, Occupational Therapist, Physiotherapist, Clinical Nurse Specialist),
pastoral care, multi-disciplinary team meetings with staff and family carers,
referral to community services, and dementia awareness training for day
and residential service care staff

Staff: 1 x Principal Clinical Psychologist, 1 x Coordinator, 1 x Consultant

Psychiatrist in Intellectual Disability, 1 x Consultant Psychiatrist in Intellectual
Disability, 1 x Senior Registrar in Psychiatry, 1 x Registrar in Psychiatry, 1 x
Registrar in Psychiatry, 1 x Assistant Psychologist, 1 x Clinical Nurse Specialist

Services available to people under 65: Yes

Services available to people with intellectual disabilities: Yes

24
 16

Memory Clinic, St Columba’s Hospital,

Co. Kilkenny
Location and Contact: Memory Clinic, St Columba’s Hospital, Thomastown,
Co. Kilkenny Tel: 056 775 4825

Profile: To provide a diagnosis and create a pathway to relevant follow up

services and supports as needed

Catchment area: Co. Kilkenny and surrounding area

Frequency: Twice a month

Referral: GP

Funding: HSE

Costs: No cost to patients

Post-diagnostic support: All local community services e.g. Occupational

Therapist, Physiotherapist, Public Health Nurse and other referrals as
necessary. The Alzheimer Society in Kilkenny provides access to carer
support group that is run once a month and day care. Referral to community
groups i.e. Kilkenny Contact and DREAM, a peer support group for people
post-diagnosis, run twice monthly in Kilkenny city facilitated by nurses from
the Memory Clinic. There is a phone follow up for all patients providing
additional support

Staff: 2 x Consultant, 1 x Occupational Therapist, 1 x Clinical Nurse Manager,

1 x Dementia Staff Nurse, 1 x Administrator

Services available to people under 65: Yes

Services available to people with intellectual disabilities: Yes

25
 17

Cognitive Assessment Service, St Fintan’s

Hospital, Portlaoise, Co. Laois
Location and Contact: Cognitive Assessment Service, Psychiatry of Later
Life, Block Road, Portlaoise, Co. Laois Tel: 057 867 0245

Profile: For specialist assessment, diagnosis, advice and treatment of people

with dementia and other cognitive disorders. A nurse-led service, with
multi-disciplinary input

Catchment area: Laois and Offaly

Frequency: Two days a week

Referral: GPs, hospital consultants, psychiatry

Funding: HSE

Costs: No cost to patients

Post-diagnostic support: Cognitive Rehabilitation Therapy. Carer support

groups run under Psychiatry of Later Life

Staff: 1 x Nurse, 1 x Consultant with support from multidisciplinary team

e.g. if required Occupational Therapist functional assessment,
neuropsychological testing, Speech and Language Therapist, Social Worker

Services available to people under 65: Yes

Services available to people with intellectual disabilities: Yes

26
 18

Memory Clinic, Co. Louth

Location and Contact: Memory Clinic (Cognitive Disorders Service), Mental
Health Services for Older People, St Brigid’s Complex, Kells Road, Ardee, Co.
Louth Tel: 041 685 0665 Fax: 041 685 3766

Profile: Multidisciplinary Memory Clinic embedded within a community

based Mental Health Services for Older People offering evaluation and
diagnosis for people with cognitive disorders. Also focuses on post-
diagnosis information, advice and management of the clinical condition.
Runs collaboratively with Medicine for the Elderly and input from Radiology
at Our Lady of Lourdes Hospital. While separate services, the Louth Memory
Clinic is integrated with the Meath Memory Clinic by way of shared
streamlined clinical pathways and evaluation procedures and a trimester
integrated meeting attended by both teams with representation from
Medicine for the Elderly

Catchment area: North Louth

Frequency: One day per week

Referral: GPs, Geriatricians and Liaison Psychiatry

Funding: HSE

Costs: No cost to patients

Post-diagnostic support: includes access to information, advice and

psychological support regarding the management of cognitive disorders

Staff: 1 x Consultant Old Age Psychiatrist, 1 x Clinical Neuropsychologist, 1

x Community Mental Health Nurse, 1 x Medical Secretary, 1 x Occupational
Therapist, 1 x Clinical Nurse Manager, 1 x Community Nurse, 1 x Social
Worker

Services available to people under 65: Yes

Services available to people with intellectual disabilities: Yes (mild

intellectual disability)

27
 19

Navan Cognitive Service

Location and Contact: Memory Clinic (Cognitive Disorders Service),
An Re Orga, Kennedy Road, Navan, Co Meath Tel: 046 905 9002

Profile: Multidisciplinary Memory Clinic embedded within a community

based Mental Health Services for Older People. It focuses on the diagnosis
and treatment of cases of suspected cognitive impairment. A screening visit
is performed at home within one to two weeks of receiving the referral and
MRI brain scan is ordered. Full Cognitive Clinic assessment (Doctor, Senior
Social Worker & Neuropsychologist/Psychologist) takes place thereafter.
Diagnosis is made at multidisciplinary team consensus meeting and is
disclosed to client (and families if desired) at a multidisciplinary team
disclosure meeting. If treatment is initiated, clients are reviewed at four to
six weeks. Cases of MCI/unclear cases are followed up annually.The Memory
Clinic runs collaboratively with Medicine for the Elderly and input from
Radiology at Our Lady of Lourdes Hospital. While separate services, the
Meath Memory Clinic is integrated with the Louth Memory Clinic by way of
shared streamlined clinical pathways and evaluation procedures and a
trimester integrated meeting attended by both teams with representation
from Medicine for the Elderly

Catchment area: Sector area Co. Meath

Frequency: Once a week

Referral: GPs, Consultant Physicians, Consultant Psychiatrists

Funding: HSE

Costs: No cost to patients

28
Post-diagnostic support: Senior Social Worker/Psychologist offers post-
diagnostic counselling if required and to all people under 65 years and their
families. Clients can attend the six week Memory Strategy Group or the nine
week Living Well with Dementia group depending on suitability

Staff: The Memory Clinic is part of the Psychiatric Service's multidisciplinary

team. 1 x Consultant Psychiatrist, 1 x NCHD (non-consultant hospital
doctor), 1 x Social Worker, 1 x Occupational Therapist, 1 x Psychologist, 1 x
Clinical Neuropsychologist (.2 WTE*) 1 x Clinical Nurse Manager, 2 x Mental
Health Nurse

Services available to people under 65: Yes

Services available to people with intellectual disabilities: Yes

* WTE - whole time equivalent

29
 20

Midland Regional Hospital, Memory Clinic,

Co. offaly
Location and Contact: Midland Regional Hospital, Memory Clinic,
Tullamore, Co. Offaly Tel: 057 935 9779

Profile: Early diagnosis, intervention in Behavioural Agitated Dementia,

monitoring of care needs

Catchment area: Laois, Offaly, Westmeath

Frequency: Once a month

Referral: GP, Consultants

Funding: HSE

Costs: No cost to patients

Post-diagnostic support: No onsite support available. There may be

fluctuating access to Cognitive Rehabilitation Therapy. Local psychiatry
services are split between Westmeath and Offaly

Staff: 1 x Consultant Geriatrician, 1 x Non Consultant Hospital Doctor e.g.

Registrar or Senior House Officer depending on schedule

Services available to people under 65: Yes

Services available to people with intellectual disabilities: No

30
 21

Midland Regional Hospital Memory Clinic,

Mullingar, Co. Westmeath
Location and Contact: Midland Regional Hospital Memory Clinic,
Mullingar, Co. Westmeath Tel: 044 939 4528

Profile: Memory Clinic provides Consultant assessment of cognition,

diagnosis, intervention and post-diagnosis management. In addition,
comprehensive physical assessment

Catchment area: Longford, Westmeath, Laois, Offaly; referrals also accepted

from other counties

Frequency: Twice monthly

Referral: Consultant and GP only

Funding: HSE

Costs: No cost to patients

Post-diagnostic support: Access to general community supports e.g.

Public Health Nurse/community services/home care packages and the
Alzheimer Society of Ireland Longford Branch (no Westmeath branch).
Psychiatry of Later Life will support day care and community Mental Health
Nurse review if behavioural and psychological symptoms of
dementia/mood issues are prominent

Staff: 1 x Consultant Geriatrician. Supported by referrals to Psychiatry of

Later Life services, Senior Clinical Neuropsychologist, Senior Occupational
Therapist

Services available to people under 65: Yes

Services available to people with intellectual disabilities: Yes

31
 22

Wexford General Hospital Memory Clinic,

Co. Wexford
Location and Contact: Wexford General Hospital Memory Clinic, Day
Hospital for Older People, Wexford General Hospital, Wexford
Tel: 053 915 3270

Profile: To provide assessments to those who are worried about their

memory, investigate further if there is an indication same, for example,
CT/bloods/in-depth cognitive assessments, diagnose, educate, treat and
support the person, also reassure the worried well

Catchment area: Co. Wexford

Frequency: Once a month

Referral: General Practitioners, Allied Health Professionals, Nurses, Public

Health Nurses, Registered General Nurses

Funding: HSE

Costs: No cost to patients

Post-diagnostic support: Recently established nurse-led memory review

clinic. People diagnosed with dementia and their families may receive follow
up education and support around their diagnosis. Occupational Therapist
provides one-to-one memory strategy sessions and they are looking at
providing this as a group session. Information sessions are also provided

Staff: 2 x Consultant Geriatricians, 1 x Clinical Nurse Manager, 1 x Health

Care Assistant, 1 x Ward Clerk. Access to Occupational Therapist

Services available to people under 65: Yes

Services available to people with intellectual disabilities: Yes

32
 23

MuNSteR
Geriatricians Memory Clinic,
St Finbarr's Hospital, Cork
Location and Contact: Assessment and Treatment Centre, St Finbarr's
Hospital, Douglas Rd, Cork Tel: 021 492 3298

Profile: To assist, support and diagnose the older adult with cognitive
impairment whose cognitive changes affect their daily functioning

Catchment area: Co. Cork and Co. Kerry

Frequency: One day per week

Referral: GP and Consultant

Funding: HSE

Costs: No cost to patients

Post-diagnostic support: Onsite Dementia Coordinator. A Memory

Intervention Support Clinic is held fortnightly. An Alzheimer Café is run once
a month

Staff: 1 x Consultant, 1 x Registrar, 3 - 4 Nurses, 2 x Clerical staff, 2 x UCC

researchers

Services available to people under 65: This will depend on the referral

Services available to people with intellectual disabilities: No

33
 24

St Ita's Day Hospital Memory Clinic,

Limerick
Location and Contact: St Ita's Community Hospital, Newcastle West,
Co. Limerick Tel: 069 66552/66525

Profile: To assess, provide diagnosis and refer to support services as

appropriate

Catchment area: Co. Limerick, South Tipperary, North Kerry, North Cork

Frequency: Every two months

Referral: GP and Hospital Consultant

Funding: HSE

Costs: No cost to patients

Post-diagnostic support: Dementia Advisor linked with the Alzheimer

Society attends clinic and can provide support to patient and relatives

Staff: 1 x Consultant Geriatrician, 2 x Consultant Psychiatrist, 1 x

Occupational Therapist, 1 x Nurse Co-ordinator, 1 x Dementia Adviser
(Alzheimer Society)

Services available to people under 65: Yes

Services available to people with intellectual disabilities: If appropriate

34
 25

Memory Clinic, St Patrick's Hospital,

Cashel, Co. tipperary
Location and Contact: Memory Clinic, St Patrick's Hospital, Cashel,
Co. Tipperary Tel: 062 70325

Profile: A multidisciplinary team that provides a diagnostic service with

referral to appropriate supports in the event of a diagnosis of dementia/MCI

Catchment area: South Tipperary geographical area

Frequency: Twice monthly

Referral: GP, Hospital Doctors and Psychiatrists

Funding: HSE

Costs: No cost to patients

Post-diagnostic support: Dementia supports developed following

Genio/HSE funded project e.g. 5 Steps to Living Well with Dementia project.
Supports include: Community Clinical Nurse Specialist for dementia who
provides information and support. Peer support worker to support
individualised activity etc. There is a Memory Technology library in Clonmel
and a Cognitive Rehabilitation programme both run by Occupational
Therapists

Staff: 2 x Geriatricians, 1 x Psychiatrist for Older persons, 1 x Psychologist,

2 x Nurse, 1 x Advanced Nurse Practitioner

Services available to people under 65: Yes

Services available to people with intellectual disabilities: No

35
 Location of Memory
Clinics in Ireland
Derry
Donegal
1. Memory Clinic, Roscommon Antrim

Hospital, Roscommon
Tyrone
2. Bloomfield Hospital, Memory Clinic,
Dublin Leitrim Armagh Down
Fermanagh

3. Memory Assessment & Support Sligo

Monaghan

Clinic, Connolly Hospital, Dublin

Cavan 18
Mayo
Louth
4. Memory Clinic, St Columcille's Roscommon Longford

Hospital, Loughlinstown, Meath

1 21 19 5
Co. Dublin 2
Westmeath 11 6 Dublin
Galway 8 7 12
5. The Dementia Advisory Resource 13
9 3 4
Offaly 15
Centre, Daughters of Charity Service, 20
Kildare
St Joseph's Centre, Clonsilla, Dublin 17
Wicklow
Laois
Clare
6. Highfield Healthcare,
Carlow
Memory Clinic, Co. Dublin
Kilkenny 14
Tipperary

7. Mater Hospital Memory Clinic, Limerick

16 Wexford
24
25
Dublin 22

8. Mercer's Memory Clinic, Kerry Waterford

St James's Hospital, Dublin Cork 23

9. St John of God Memory

Assessment Service, Co. Dublin

10. Memory Assessment and Support

Clinic, St Mary’s Day Hospital, 15. Memory Clinic (Intellectual 20. Midland Regional Hospital,
Dublin Disability), St John of God Memory Clinic, Co. Offaly
Community Services Ltd.,
11. Multidisciplinary Memory Clinic,
Liffey Region Kildare Services, 21. Midland Regional Hospital Memory
St Patrick’s Mental Health Services,
Co. Kildare Clinic, Mullingar, Co. Westmeath
Dublin
16. Memory Clinic, 22. Wexford General Hospital Memory
12. Memory Clinic, Carew House,
St Columba’s Hospital, Clinic, Co. Wexford
St Vincent's University Hospital,
Dublin Co. Kilkenny 23. Geriatricians Memory Clinic,
17. Cognitive Assessment Service, St Finbarr's Hospital, Cork
13. Memory Assessment Clinic,
Tallaght Hospital, St Fintan’s Hospital, Portlaoise, 24. St Ita's Day Hospital Memory Clinic,
Dublin 24 Co. Laois Limerick
14. Memory Clinic, Sacred Heart 18. Memory Clinic, Co. Louth 25. Memory Clinic, St Patrick's Hospital,
Hospital, Carlow Cashel, Co. Tipperary
19. Navan Cognitive Service, Co. Meath

36
Summary

Most experts in the field agree that the early assessment and diagnosis of dementia
is essential for the treatment and support of both the individual with cognitive
impairment and their families. As the Irish National Dementia Strategy
acknowledges GPs play a key role in the diagnosing of dementia "a confirmatory
definitive diagnosis and identification of the dementia sub-type remains a
specialist task." As a result there is a need for memory clinic services and this
demand is likely to increase.

In Northern Ireland there are memory clinics in each of the five Health and Social
Care Trusts and despite complaints over waiting times for appointments they have
achieved a 75% diagnosis rate. (Alzheimer Research UK). In the Republic of Ireland
the situation is much different.

A recent review looking at Memory Clinics in Ireland (Fagan, 2017) has shown that
Memory Clinics are not available in every HSE Community Health Organisation
area and there is considerable variability across existing clinics, in relation to
staffing composition, frequency of service, resources and costs.

Our ageing population and the increasing numbers of people likely to develop a
dementia in the future means there is an urgent need to invest into the expansion
and enhancement of these important services.

37
 Finally, many people still believe that memory loss and cognitive problems are a
normal part of ageing and do not know they can seek medical help. Others delay
making an appointment to see a doctor because they have a fear of being given a
diagnosis of dementia.

In fact, memory problems can result from a variety of medical conditions and
making an appointment with a family doctor to discuss concerns about memory
loss is the first step towards getting an accurate diagnosis. Pending the GP’s
assessment and decision, a referral to a Memory Clinic may help to rule out the
existence of other conditions, to identify the dementia subtype or provide
treatments and strategies to reduce significant memory problems in the future.

This booklet has attempted to bring together all available information on Memory
Clinic services in Ireland. It is hoped it will be a useful resource to both the public
and to health service professionals.

38
References
Alzheimer's Research UK Dementia Statistics Hub
https://www.dementiastatistics.org/statistics/diagnoses-in-the-uk/

Bruce, I. (2004) ‘Memory clinics’, Fresenius Kab!, 1(2): 5.

Cahill, S., O’Shea, E. and Pierce, M. (2012) Creating Excellence in Dementia

Care: A Research Review for Ireland’s National Dementia Strategy, Living with
Dementia Research Programme, Trinity College Dublin, and Irish Centre for Social
Gerontology, National University of Ireland, Galway, Dublin and Galway.

Department of Health (2009) Living Well with Dementia: A National Dementia

Strategy, Department of Health, London.

Department of Health (2014) The Irish National Dementia Strategy, Department

of Health, Dublin

Fagan, M. (2017) Do Patients in the Republic of Ireland Face a Postcode Lottery

for Dementia Tests, http://www.thedetail.tv/articles/patients-in-republic-face-
patchy-memory-services-and-lengthy-waits

Jolley, D., Benbow, S. and Grizzell, M. (2006) ‘Memory clinics’, Post-graduate

Medical Journal, 82: 199-206.

Lindesay, J., Marudkar, M., Van Diepen, E. and Wilcock, G. (2002) ‘The second
Leicester survey of Memory Clinics in the British Isles’, International Journal of
Geriatric Psychiatry, 17: 41-47.

Maher, L. (2009) An Exploration of Memory Clinic Services in the Republic of

Ireland, Masters Thesis, Trinity College, Dublin.

Moniz-Cook, E. and Woods, R.T. (1997) ‘The role of Memory Clinics and
psychosocial intervention in the early stages of dementia’, International
Journal of Geriatric Psychiatry, 12: 1143-1145.

39
 Acknowledgements
Thank you to the National Dementia Office who carried out the initial data
collection for this booklet.

A Masters thesis titled 'An Exploration of Memory Clinic Services in the Republic of
Ireland' was undertaken by Laura Maher in 2009. The thesis collated information
for the first time in Ireland on the topic of Memory Clinics and facilitated the initial
publication of this booklet. The authors would like to thank Laura Maher for her
work in this area. Thanks are also extended to all the Memory Clinic staff who
completed the questionnaires.

Authors
Matthew Gibb and Dr Emer Begley.

Many thanks to Associate Professor Suzanne Cahill, Vanessa Moore and Dr Maria
Pierce for their work on previous iterations of this booklet.

The Dementia Services Information and Development Centre's mission is to

promote excellence in all aspects of dementia care in Ireland so that people can
live well with dementia and enjoy a good quality of care. Its aim is to promote an
informed understanding and awareness of dementia, provide evidence-based
education and training to practitioners working in the field, conduct and support
local and international research and evaluation, and provide a consultancy and
information service both at an individual and corporate level. Our ultimate aim is
to have people eschew their fears and the stigma often associated with dementia
to enable the individual to live a rich and more fulfilling life.

The HSE’s National Dementia Office (NDO) was established in 2015. The NDO
provides leadership at a system level, with a role and function to oversee the
implementation, monitoring, and ongoing evaluation of the National Dementia
Strategy.

The vision of the office is that people with dementia and their family carers receive
the supports and services they need to fulfil their potential and to maintain their
identity, resilience and dignity as valued and active citizens in society.

40
useful websites

l www.alzheimer.ie
l www.alzheimercafe.ie

l www.dementia.ie

l www.understandtogether.ie

l www.hse.ie

l www.memoryclinics.ie

41
 Notes

42
 www.dementia.ie
www.memoryclinics.ie
www.understandtogether.ie