How do doctors deliver a diagnosis of dementia in memory clinics?

Jemima Dooley*, Nick Bass, Rose McCabe

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

7 Citations (Scopus)
300 Downloads (Pure)

Abstract

Background: Dementia diagnosis rates are increasing. Guidelines recommend that people with dementia should be told their diagnosis clearly and honestly to facilitate future planning. Aims: To analyse how doctors deliver a dementia diagnosis in practice. Method Conversation analysis was conducted on 81 video-recorded diagnosis feedback meetings with 20 doctors from nine UK memory clinics. Results: All doctors named dementia; 59% (n = 48) approached the diagnosis indirectly but delicately ('this is dementia') and 41% (n = 33) approached this directly but bluntly ('you have Alzheimer's disease'). Direct approaches were used more often with people with lower cognitive test scores. Doctors emphasised that the dementia was mild and tended to downplay its progression, with some avoiding discussing prognosis altogether. Conclusions: Doctors are naming dementia to patients. Direct approaches reflect attempts to ensure clear diagnosis. Downplaying and avoiding prognosis demonstrates concerns about preserving hope but may compromise understanding about and planning for the future.

Original languageEnglish
Pages (from-to)239-245
Number of pages7
JournalBritish Journal of Psychiatry
Volume212
Issue number4
Early online date27 Mar 2018
DOIs
Publication statusPublished - Apr 2018

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