After the primary care team makes the necessary referrals for the patient, regular points of follow-up should be established (e.g., after 2 weeks, after 1 month). 

In addition to ensuring that individuals living with dementia and their caregivers have been able to access needed resources, this process can be helpful for: 

  • Confirming that the professionals, agencies, or organizations are effectively providing needed supports. A follow-up call may reveal whether these resources are contacting the referred patients as requested and providing helpful services.
  • Refining the referral process and list. Patients and families may be able to provide useful feedback on which services they find most helpful. 
  • Supporting patients and families in any outreach that they may need to do on their own. They may benefit from additional guidance on which resources to contact about specific issues and the types of services to request.
  • Reducing crisis situations. A 5-minute conversation may go a long way in helping patients or their family members to identify solutions that can prevent a worsening clinical or social scenario and help to prepare for future decline that might otherwise result in a crisis situation.


Refer | Approaches to Implement

Overview | The Referral Process | Conduct Regular Follow-up | Culturally Competent Conversations
Communicating about Clinical Trials | Refer References