Abstract
OBJECTIVE: To show that family physicians have an important role in caring for patients recently diagnosed with dementia. SOURCES OF INFORMATION: This article is based on the authors' clinical experience and on the recommendations of the Canadian Consensus Conference on Dementia. MAIN MESSAGE: The authors touch on themes often ignored in the literature, such as issues surrounding the first time patients and their families are confronted with a diagnosis of dementia. We show the advantages of informing patients of the diagnosis and refute arguments for keeping it a secret. We then describe aspects of anticipatory counseling, which should begin as soon as the diagnosis is made: natural evolution of the disease, risk factors, power of attorney, driving, medical follow up, risks of polypharmacy, resources for psychological support of caregivers, and orientation to community resources (for helping patients remain at home). CONCLUSION: Physicians must inform patients and their families of a diagnosis of dementia and provide anticipatory counseling so that families can prepare for the long-term responsibility of caring for someone with this disease.
Full Text
The Full Text of this article is available as a PDF (159.5 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Cohen C. A., Pringle D., LeDuc L. Dementia caregiving: the role of the primary care physician. Can J Neurol Sci. 2001 Feb;28 (Suppl 1):S72–S76. doi: 10.1017/s0317167100001232. [DOI] [PubMed] [Google Scholar]
- Drickamer M. A., Lachs M. S. Should patients with Alzheimer's disease be told their diagnosis? N Engl J Med. 1992 Apr 2;326(14):947–951. doi: 10.1056/NEJM199204023261410. [DOI] [PubMed] [Google Scholar]
- Feldman H., Kertesz A. Diagnosis, classification and natural history of degenerative dementias. Can J Neurol Sci. 2001 Feb;28 (Suppl 1):S17–S27. doi: 10.1017/s0317167100001177. [DOI] [PubMed] [Google Scholar]
- Lindsay J., Hébert R., Rockwood K. The Canadian Study of Health and Aging: risk factors for vascular dementia. Stroke. 1997 Mar;28(3):526–530. doi: 10.1161/01.str.28.3.526. [DOI] [PubMed] [Google Scholar]
- Myers R. H., Schaefer E. J., Wilson P. W., D'Agostino R., Ordovas J. M., Espino A., Au R., White R. F., Knoefel J. E., Cobb J. L. Apolipoprotein E epsilon4 association with dementia in a population-based study: The Framingham study. Neurology. 1996 Mar;46(3):673–677. doi: 10.1212/wnl.46.3.673. [DOI] [PubMed] [Google Scholar]
- Patterson C., Gauthier S., Bergman H., Cohen C., Feightner J. W., Feldman H., Grek A., Hogan D. B. The recognition, assessment and management of dementing disorders: conclusions from the Canadian Consensus Conference on Dementia. Can J Neurol Sci. 2001 Feb;28 (Suppl 1):S3–16. doi: 10.1017/s0317167100001165. [DOI] [PubMed] [Google Scholar]
- Schulz R., O'Brien A. T., Bookwala J., Fleissner K. Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontologist. 1995 Dec;35(6):771–791. doi: 10.1093/geront/35.6.771. [DOI] [PubMed] [Google Scholar]