Memory problems are one of the first symptoms of dementia. Other signs are problems involving thinking, understanding, language and judgement.

Memory loss is more commonly found in people over the age of 65. This can can cause many problems for a person with diabetes, from forgetting to take their medication or eat their meals, to becoming anorexic and having difficulties feeding and so becoming undernourished, to an inability to communicate their needs so losing the capability to manage their diabetes altogether.

Just as with screening for depression, a cognitive assessment at the time of admission to the care home and then at annual intervals is recommended. This tests the workings of a person's thought processes.

A simple bedside test of cognition screening called the ‘Mini-Cog’, which is a combination test of clock drawing and answering several questions which test recall ability, has been developed by The Institute of Diabetes for Older People and NHS Diabetes and is currently being trialled in various areas.

This will be adapted for use in care homes in late 2010.

Care home staff, once they are aware of any problems, may be able to help at mealtimes by: 

• serving one course at a time to reduce confusion
•  using the resident’s own crockery so giving greater familiarity
• allowing grazing with extra time provided for the resident to return to the plate
• encouraging low glycaemic index dairy products such as ice cream or milk shakes when other food is refused so reducing the risk of a ‘hypo’
• reducing environmental stimuli such as the TV in the dining area if aggressive/negative behaviours are present during mealtimes.

Nutrition support may be needed for some residents so the dietitian would be asked to visit.

Reviewed March 2010
Next review September 2011