6-Monthly Memory Assessment and Review

FOLLOW-UP QUESTIONNAIRES FOR MEMORY TREATMENT REVIEW

Please complete these before your 6-month review appointment

This 6-monthly review is for patients who have started or are continuing memory medication. This review focuses on what has changed since your last appointment. It helps us understand whether the treatment is providing benefit, whether there are side effects, and whether there have been changes in memory, function, mood, behaviour, safety, driving or carer stress.

The review is not just about memory test scores. Stability, daily function, tolerability and carer observations are equally important when deciding whether treatment should continue.

A relative, family member or carer should complete the carer forms wherever possible, as they may notice changes that the patient may not recognise.

What you need to do

  • The patient should complete the patient questionnaires as below
  • A relative, family member, or carer should complete the informant questionnaires
  • Please complete them at least 24 hours before your appointment, where possible.
  • Please have an up-to-date medication list, pulse/heart rate reading, weight and any recent GP or hospital letters available if possible.

You will have an option to ‘Stop and Resume’ if you need a break to complete. You will get the link by email.

Tailored support

Patient forms

These forms should usually be completed by the patient, with help if needed.

Medication Side Effect Checklist

Questions about possible side effects such as nausea, diarrhoea, dizziness, sleep disturbance, vivid dreams, weight loss, slow pulse, fainting or falls. (3-4min)
Click Here

Driving and Safety Review

Questions about current driving, DVLA notification, getting lost, accidents, near misses, family concerns and home safety. (2-3min)
Click Here

Mood and Wellbeing (GDS-15)

Short questionnaire about mood (3-4 min)
Click Here

Anxiety Questionnaire
(GAI-20)

Short questionnaire about anxiety and worry (3-4 min)
Click Here

Relative / Carer forms

These forms are best completed by a relative, family member, or carer who knows the patient well.

Medication Benefit Review

Questions about your current memory medication, dose, regularity, perceived benefit and whether you wish to continue. (3-5min)
Click Here

Function and Independence Review
(BADLS)

Questions about day‑to‑day function and practical abilities (3-4 min)
Click Here

Behaviour and mood change (NPI-Q)

Questions about agitation, hallucinations, sleep, wandering, falls, medication errors, kitchen safety, scams, self-neglect and safeguarding concerns. (4-5min)
Click Here

Carer Global Impression of Change

A brief overall carer judgement of whether the patient is better, stable or worse compared with 6 months ago.
Click Here

Before you begin

  • There are no right or wrong answers
  • Please answer honestly and based on the last 6 months.
  • If help is needed with the online form, a relative may assist
  • Patient forms should reflect the patient’s own feelings
  • Carer forms should reflect the carer’s observations
  • It is useful to have the current medication list available.
  • If possible, please provide recent weight, pulse/heart rate and blood pressure readings.

If you cannot complete the forms

Please still attend your appointment. We can go through the assessment forms during the consultation if needed.

Please complete these forms at least 24 hours before your appointment if possible.
They help us decide whether the current treatment should be continued, increased, changed, combined with another medication or stopped.