When the results of my mother’s brain scan finally came through from her local memory service, the call came from a nurse who admitted she didn’t understand the report in front of her. Since I was a doctor, she wondered whether I might talk her through it.

So I found myself going through my own mother’s scan results and explaining what each finding meant to the person whose job it was to explain it to us.

I don’t hold it against the nurse, who’d never been trained to interpret brain imaging. She was there because the service she worked for – just outside London – had no doctor of its own.

Nurses and nursing assistants carried out the assessments, and difficult cases were saved up for the few hours each week, when a consultant visited. He’d been on leave for the past week, so no doctor had been available at all.

That phone call, 18 months ago, came at the end of a very long road.

Around 15 years earlier, a routine eye test had shown Mum had quadrantanopia, loss of vision affecting the same quarter of the visual field in both eyes. This suggests a problem in the brain itself, and Mum was sent for an urgent scan. This showed she’d had a stroke in her temporal lobe, which carries some of the nerve fibres responsible for vision and plays an important part in memory and emotion.

The scan revealed small strokes in her frontal lobes too, which govern emotions, planning, organisation and personality. Tests showed she had very high blood pressure and cholesterol, two of the main risk factors for vascular dementia.

When I went with Mum to see the neurologist a few weeks after the scan, he asked whether we’d noticed any changes in her behaviour; later, talking about it with my younger sister, we realised we had.

The changes had been subtle, and we’d put them down to other stresses in her life.

Mum had been vague and easily confused for a while, particularly with anything that needed planning – and irritable, sometimes angry, over nothing at all. She’d always been a proud woman who looked after herself, yet she had started appearing in dirty clothes.

But as we walked out of the appointment Mum insisted everything was fine.

What happened next was all the harder to watch because of who Mum had always been.

She was a fantastic mother, incredibly warm, kind and funny. She left school at 15 but loved literature, theatre and art – and our summer holidays were packed with visits to museums, our evenings spent listening to her read. She knows countless poems and whole passages of Shakespeare by heart.

She had an extraordinary work ethic too, going to evening classes, taking A-levels and eventually training as a teacher.

But over the years following that appointment, things slowly worsened. She’d become distraught over small things and shrug off serious ones. She was uncharacteristically blunt or rude to friends.

She got into a muddle with money and ended up in debt, and there were a few fires in her kitchen after she forgot about pans on the hob. She couldn’t see the danger, and after an occupational therapist visited, we eventually had to disconnect the cooker because she refused to stop using it.

Once she rang me in tears to say that her mobile phone was talking to her landline. As far as we could work out, she’d called her home number by mistake, but we never got to the bottom of it – and the next day she had no memory of the two-hour conversation we’d had about it.

Whenever we suggested she needed help, she was furious. Her GP tried several times to refer her to the memory clinic, and each time she refused. She blamed all her difficulties on her eyes, even though specialists said her vision was generally excellent.

My sister and I grew increasingly desperate and worried she was no longer safe at home, until eventually something clicked and she agreed to be seen.

Ours is far from an unusual story. Many families spend years trying to persuade a loved one to accept help. What I hadn’t expected was that once she eventually agreed, she would wait another 18 months to be assessed.

When she did finally get a scan, the report contained two findings.

The first was she has vascular dementia, where damage to the blood vessels gradually reduces vital oxygen supply to parts of the brain.

The second was a less common condition, normal pressure hydrocephalus, where the fluid that cushions the brain builds up and presses on surrounding tissue.

This is one of the few causes of dementia-like symptoms that can sometimes be reversed. If a neurosurgeon thinks a patient is suitable, a thin tube can be inserted to drain the excess fluid, and some people improve dramatically.

I told the nurse that Mum needed referring to neurosurgery for an opinion, and she replied that she wasn’t permitted to refer patients to other specialities, so we’d have to go back to the GP and ask them to do it.

It’s been 18 months since that phone call, and Mum, now 80, still hasn’t seen a neurosurgeon.

She can no longer walk or get out of bed on her own, she is lifted into her chair with a hoist, she is doubly incontinent and two carers come in four times a day to look after her.

Her decline has followed the pattern typical of vascular dementia, with periods of stability broken by sudden drops.

She has good days and bad days. She still recognises us, though she has become apathetic and has lost interest in the books she once loved.

She is content, though. We can still laugh together, and she no longer seems distressed when she struggles to understand or remember something.

Superficially she seems fine – and she’ll cheerfully tell you about going to the shops that day and who she chatted to, even though she is bedbound and the only people she has seen are her carers.

My sister and I are left wondering how much of what we are watching is the dementia, which nobody can undo, and how much is the hydrocephalus, which perhaps somebody could have treated.

Mum’s dementia diagnosis came with a leaflet listing local charities that ran drop-in sessions, and then she was discharged from the memory service.

That was it. Nobody arranged to see her again, nobody was named as the person we could ring, and no one offered her any help with the fear and distress the illness was causing her – even though guidance from the National Institute for Health and Care Excellence (NICE) is clear that people with dementia should be offered psychological support.

I am dual-trained as both a general adult psychiatrist and old-age psychiatrist, so I know the system from the inside.

I know what should happen, what to ask for and whom to chase. Yet none of that has been enough to get my own mother the care she needs.

We’ve called the GP many times – and the GP, who has been very good, has chased the neurosurgery referral. But Mum is still waiting. Families without a doctor among them must find it almost impossible.

The patient’s family suffers too. Alzheimer’s Society figures show that four in five unpaid dementia carers have reached crisis point at least once, and seven in ten say their mental or physical health has suffered.

What makes it so hard to bear is that I know how differently it can be done, because I have worked in a service that gets it right.

While I was training in old-age psychiatry, I worked at Camden Memory Service in north London – and the contrast with what Mum has been through could hardly be starker.

In Camden, the aim is that the initial assessment happens within six weeks, and the diagnosis and care plan should be discussed with the patient within 18 weeks of referral.

Every patient is assessed by a doctor or a senior nurse, and the team around them includes two consultant psychiatrists, resident doctors, specialist dementia nurses, psychologists, an occupational therapist and assistant practitioners.

The nurse assessors work alongside doctors in the same team, so anything unusual or complex can be seen by a consultant and acted on straight away.

Everyone diagnosed is also given a ‘named worker’ whom they or their family can contact with worries or questions, or if things seem to be changing.

An assessment typically involves three appointments: one to carry out the assessment and arrange investigations such as brain scans; one to give the diagnosis and discuss any treatment; and a further one to answer questions the patient or family might have.

Doctors even offer home visits for patients too forgetful or frail to attend in person.

Camden’s estimated diagnosis rate was 74.3 per cent last year – well above the national figure of 66.3 per cent (London generally tends to do better, but Camden also outperforms the London average).

Most strikingly, nobody is discharged. People stay under the memory service for the rest of their lives, unless they move out of the borough.

If they move into a nursing home, a dedicated care home liaison team can review them there to support both the patient and the staff – invaluable when dementia brings agitation and distress, which care homes often struggle to manage.

There is also a monthly drop-in session where families can get information and advice.

The model has been running for more than ten years, with neighbouring Islington providing the same service. The key is the medically-led diagnosis, which provides the foundation every-thing else rests on.

It’s important to get the diagnosis right at the beginning. If you know exactly what you’re dealing with, you get the right treatment and support, with a personalised plan – including identifying any possible reversible causes of cognitive impairment.

In other words, Camden offers precisely what my own parent’s service couldn’t.

And Mum’s experience is depressingly common.

The National Audit of Dementia, run by the Royal College of Psychiatrists, reported this summer that the median wait from being referred for assessment in a memory clinic to diagnosis has risen to 137 days.

In a single NHS trust in the North-East, overall waits ranged from 92 days to 323 days.

Where you live also determines whether you are diagnosed at all.

A report by the All-Party Parliamentary Group on Dementia in 2023 found the diagnosis rate was almost 90 per cent in Stoke-on-Trent, but just over 44 per cent in South Hams in Devon.

And patients in deprived areas are more likely to be given a vague diagnosis of ‘unspecified dementia’, according to a national survey of English memory services published this year.

This matters because the type of dementia dictates many of the things that follow.

Some medicines help in Alzheimer’s disease but not in other types, while people with dementia with Lewy bodies can react very badly to antipsychotic drugs that might be given to calm agitation.

And, as Mum’s case shows, a precise diagnosis can uncover a condition that may be treatable. Support after diagnosis is just as pitifully patchy – with one in five people diagnosed in the UK receiving no support at all, according to a report by Alzheimer’s Society earlier this year.

In other words, it’s essential that doctors are closely involved in this process.

The obvious objection to rolling out a consultant-led model, of course, is cost.

But what other service diagnosing and treating a medical condition doesn’t have doctors? Can you imagine cancer services without doctors? A doctor dropping in for a few hours a week – as in my mother’s area – is not enough.

The consultant needs to be leading the service, seeing patients and able to act on what they find.

And we should also be honest about the cost of not doing this.

Think of the 18 months my mother has spent waiting for a neurosurgeon’s opinion, during which she went from walking to being bedbound and now needs two carers four times a day.

Think of the families who give up work, the crises that end in emergency admissions, and the care home placements that break down because nobody is supporting the staff.

In the meantime, families need help now, which is why Dementia Carers Together – the Daily Mail’s campaign with Mail Force and Alzheimer’s Society – is so important.

So many carers of people with dementia face overwhelming responsibilities, too often with little more than a leaflet.

The idea is to provide carers with six-week courses (each weekly session lasting two hours), giving them vital information about their rights (what they’re entitled to medically and financially) along with practical help in dealing with loved ones as they deteriorate.

For me as a psychiatrist, what’s just as important is that carers will be taught ways to cope with the toll on their own mental health – and when and how to ask for help.

My sister is a psychotherapist, so between us we probably have more training than most families to cope with this, and yet it’s still been one of the most distressing experiences of our lives.

Dementia doesn’t get better. It lasts for the rest of a person’s life and usually becomes more difficult to manage with every passing year – yet across much of the country the NHS treats the diagnosis as the point at which its job is done. For families, that is when the hardest part begins.

My mother was handed a leaflet and discharged. But if Camden can find a way to give every patient the quality care they deserve, the rest of the health service has run out of excuses.