A timely dementia diagnosis – from recognition to decision-making across care settings
A timely dementia diagnosis – from recognition to decision-making across care settings
Many people are only diagnosed with dementia when the disease has already progressed. Patients and family members do not always seek help, and when they do, healthcare professionals do not always address concerns. In this thesis, Fleur Visser examines why it can take long before dementia is recognized and what healthcare professionals need to diagnose it timely. “Timely” here means appropriate to the situation and aligned with the preferences of the patient and their family.
The findings show that a timely diagnosis requires more than medical knowledge. General practitioners (GPs) often find it difficult to raise the possibility of dementia and discuss the choices that follow. Together with patients and family, they need to decide between options such as wait-and-see, conducting tests in primary care, or a memory clinic referral. This conversation becomes even more challenging when a patient does not acknowledge symptoms and declines further testing. Some GPs feel unsure about their ability to diagnose dementia or question the value of a diagnosis. Clear guidance on roles and responsibilities, and collaboration with other professionals, such as practice nurses, can help.
In hospitals, memory problems are often missed, with the risk of suboptimal care. Physicians and nurses want to consider memory problems when treating other conditions, but report needing more knowledge and time.
Visser concludes that a timely dementia diagnosis begins with open discussion of concerns, close collaboration between professionals, and an approach that recognizes the person behind the patient.