What should we tell people about dementia?

Pinner, Gill; Bouman, Walter Pierre

doi:10.1192/apt.9.5.335

Cited by 18 publications

(16 citation statements)

References 27 publications

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“…In the light of the evidence available, it is surprising that a number of authors have been able to make recommendations regarding diagnostic disclosure in dementia (Post and Whitehouse, 1995;Downs, 1999;Pinner and Bouman, 2003;Wilkinson and Milne, 2003). It has, for example, been suggested that carers should be informed of the diagnosis first (Barnes, 1997); while some carers may prefer to be informed alone (Bachman et al, 2000), others may prefer the person with dementia to be present.…”

Section: Discussionmentioning

confidence: 95%

Disclosing a diagnosis of dementia: a systematic review

Bamford

Lamont

Eccles

et al. 2004

Int J Geriat Psychiatry

246

261

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Section: Discussionmentioning

confidence: 95%

Disclosing a diagnosis of dementia: a systematic review

Bamford

Lamont

Eccles

et al. 2004

Int J Geriat Psychiatry

246

261

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“…Studies from clinic samples suggest that the majority of people with mild dementia wish to know of their diagnosis (Pinner and Bouman, 2003;De Lepelaire et al, 2004). Although we do not know so much about community samples, all practitioners should assume that the diagnosis will be discussed with the person with dementia, unless there are clear reasons not to do so.…”

Section: Communicating the Diagnosismentioning

confidence: 99%

“…A systematic review of the literature about sharing the diagnosis of dementia suggests that nonsharing or vague information about it is experienced as confusing, upsetting and difficult for some people with dementia and their families (Bamford et al, 2004). During the assessment and diagnostic process people should routinely be asked if they wish to know the diagnosis and with whom this should be shared (Pratt and Wilkinson, 2001;Pinner and Bouman, 2003).…”

Section: Communicating the Diagnosismentioning

confidence: 99%

Primary care and dementia: 1. diagnosis, screening and disclosure

Iliffe

Robinson

Brayne

et al. 2009

Int J Geriat Psychiatry

168

154

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SUMMARYObjectives To write a narrative review of the roles of primary care practitioners in caring for people with dementia in the community. Methods The systematic review carried out for the NICE/SCIE Guidelines was updated from January 2006, Cochrane Reviews were identified, and other publications found by consultation with experts. Results The insidious and very variable development of dementia syndromes makes recognition of the syndrome problematic in primary care. Dementia is probably under-diagnosed and under treated with an estimated 50% of primary care patients over 65 not diagnosed by their primary care physicians. This problem of under-diagnosis is probably not due to lack of diagnostic skills, but rather to the interaction of case-complexity, pressure on time and the negative effects of reimbursement systems. Primary care physicians often over-estimate the prevalence of dementia syndromes, but in some countries may also overestimate the prevalence of vascular dementia compared with Alzheimer's disease. Diagnosis is a step-wise process which can be aided by use of a cognitive function test, of which there are a number suitable for primary care use. Evidence based practice protocols can enhance detection rates in primary care, and there is growing evidence that communication skills in talking to people with dementia about dementia can be improved. Nevertheless there are multiple obstacles to bringing recognition forward in time, both in public awareness and professional understanding of the early changes in dementia. Conclusions There is insufficient evidence of benefit to justify population screening in primary care but earlier recognition of people with dementia syndrome is possible within primary care. The diagnosis of dementia is a shared responsibility between generalist and specialist disciplines. Primary care physicians should explore patients' ideas and concerns around their symptoms prior to referral and tentatively discuss possible diagnoses. Once the diagnosis has been confirmed, the primary care physician should provide both practical and emotional support to allow the patient and their family to come to terms with living with dementia, and refer them for additional psychosocial support if required.

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“…It is difficult to understand the reluctance to allow autonomy to take precedence over paternalism. It is clear from the work of Pinner & Bouman (2003) that people with dementia want to have all the information regarding their diagnosis. In their study they found that 92% of patients with early dementia wished to be fully informed.…”

Section: Providing Informationmentioning

confidence: 98%

Supportive psychotherapy in dementia

Junaid

Hegde²

2007

Adv. psychiatr. treat

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The role of psychotherapy for elderly people is the subject of much debate. Yet this has not resulted in a shift of resources towards increasing its availability within the UK's National Health Service. Over the past decade the pessimistic view of psychotherapy for elderly people has diminished owing to the growing evidence base and the commitment of champions in old age psychiatry and psychotherapy. However, there is still very little structured research into psychotherapy in dementia. Supportive psychotherapy is a poorly understood but very practical means of helping people with dementia to adjust to the effects of their illness. Its inherent flexibility enables individual sessions to be tailored to the patient's needs and deficits. An understanding of supportive psychotherapy and its benefits could enable clinicians to improve the quality of life of people with dementia and their carers within the ever-present constraints of limited time and resources. This article explores the use of supportive psychotherapy as a treatment option in dementia.

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What should we tell people about dementia?

Cited by 18 publications

References 27 publications

Disclosing a diagnosis of dementia: a systematic review

Disclosing a diagnosis of dementia: a systematic review

Primary care and dementia: 1. diagnosis, screening and disclosure

Supportive psychotherapy in dementia

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