Caregivers' Experience of Decision-Making Regarding Diagnostic Assessment Following Cognitive Screening of Older Adults

Overview

Journal J Aging Res

Publisher Wiley

Specialty Geriatrics

Date 2019 Jan 12

PMID 30631599

Citations 6

Authors

Jamie J Y Lee

Joanna Barlas

Claire L Thompson

Yan Hong Dong

Affiliations

Soon will be listed here.

Abstract

Targeted screening for dementia among older adults in primary healthcare has potential benefits such as better clinical outcomes and the opportunity to access services. Cognitive screening can be followed up by further diagnostic assessment to determine a diagnosis of dementia. Unfortunately, the rates of accepting further diagnostic assessment following cognitive screening are low. The objective of this study was to explore the caregivers' decision-making process regarding uptake of diagnostic assessment following positive screening results. A qualitative design was employed, and interpretative phenomenological analysis was used to analyze the data. Three major themes in caregiver decision-making were identified: gathering information, protecting the patient, and balancing obligation and convenience in caregiving. These findings suggest that the decision-making process involved effort to process information through observations of the patient and that caregivers emphasized quality of life.

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References

Johnson H, Bouman W, Pinner G . On telling the truth in Alzheimer's disease: a pilot study of current practice and attitudes. Int Psychogeriatr. 2000; 12(2):221-9. DOI: 10.1017/s1041610200006347. View

Unverzagt F, Gao S, Baiyewu O, Ogunniyi A, Gureje O, Perkins A . Prevalence of cognitive impairment: data from the Indianapolis Study of Health and Aging. Neurology. 2001; 57(9):1655-62. DOI: 10.1212/wnl.57.9.1655. View

Barbas N, Wilde E . Competency issues in dementia: medical decision making, driving, and independent living. J Geriatr Psychiatry Neurol. 2002; 14(4):199-212. DOI: 10.1177/089198870101400405. View

Kim S, Karlawish J, Caine E . Current state of research on decision-making competence of cognitively impaired elderly persons. Am J Geriatr Psychiatry. 2002; 10(2):151-65. View

Gessert C, Forbes S, Bern-Klug M . Planning end-of-life care for patients with dementia: roles of families and health professionals. Omega (Westport). 2003; 42(4):273-91. DOI: 10.2190/2mt2-5gyu-gxvv-95ne. View

Wilkinson H, Milne A . Sharing a diagnosis of dementia--learning from the patient perspective. Aging Ment Health. 2003; 7(4):300-7. DOI: 10.1080/1360786031000120705. View

van Doorn C, Gruber-Baldini A, Zimmerman S, Hebel J, Port C, Baumgarten M . Dementia as a risk factor for falls and fall injuries among nursing home residents. J Am Geriatr Soc. 2003; 51(9):1213-8. DOI: 10.1046/j.1532-5415.2003.51404.x. View

Pinner G, Bouman W . Attitudes of patients with mild dementia and their carers towards disclosure of the diagnosis. Int Psychogeriatr. 2004; 15(3):279-88. DOI: 10.1017/s1041610203009530. View

Bamford C, Lamont S, Eccles M, Robinson L, May C, Bond J . Disclosing a diagnosis of dementia: a systematic review. Int J Geriatr Psychiatry. 2004; 19(2):151-69. DOI: 10.1002/gps.1050. View

10.

Vernooij-Dassen M, Moniz-Cook E, Woods R, De Lepeleire J, Leuschner A, Zanetti O . Factors affecting timely recognition and diagnosis of dementia across Europe: from awareness to stigma. Int J Geriatr Psychiatry. 2005; 20(4):377-86. DOI: 10.1002/gps.1302. View

11.

Hirschman K, Joyce C, James B, Xie S, Karlawish J . Do Alzheimer's disease patients want to participate in a treatment decision, and would their caregivers let them?. Gerontologist. 2005; 45(3):381-8. DOI: 10.1093/geront/45.3.381. View

12.

MacQuarrie C . Experiences in early stage Alzheimer's disease: understanding the paradox of acceptance and denial. Aging Ment Health. 2005; 9(5):430-41. DOI: 10.1080/13607860500142853. View

13.

Iliffe S, Wilcock J, Haworth D . Obstacles to shared care for patients with dementia: a qualitative study. Fam Pract. 2006; 23(3):353-62. DOI: 10.1093/fampra/cmi116. View

14.

Boustani M, Perkins A, Fox C, Unverzagt F, Austrom M, Fultz B . Who refuses the diagnostic assessment for dementia in primary care?. Int J Geriatr Psychiatry. 2006; 21(6):556-63. DOI: 10.1002/gps.1524. View

15.

Karel M, Moye J, Bank A, Azar A . Three methods of assessing values for advance care planning: comparing persons with and without dementia. J Aging Health. 2007; 19(1):123-51. PMC: 4859331. DOI: 10.1177/0898264306296394. View

16.

Park M, Chesla C . Revisiting Confucianism as a conceptual framework for Asian family study. J Fam Nurs. 2007; 13(3):293-311. DOI: 10.1177/1074840707304400. View

17.

Cahill S, Clark M, OConnell H, Lawlor B, Coen R, Walsh C . The attitudes and practices of general practitioners regarding dementia diagnosis in Ireland. Int J Geriatr Psychiatry. 2008; 23(7):663-9. DOI: 10.1002/gps.1956. View

18.

Park Y, Kim B . Asian and European American cultural values and communication styles among Asian American and European American college students. Cultur Divers Ethnic Minor Psychol. 2008; 14(1):47-56. DOI: 10.1037/1099-9809.14.1.47. View

19.

Boustani M, Perkins A, Monahan P, Fox C, Watson L, Hopkins J . Measuring primary care patients' attitudes about dementia screening. Int J Geriatr Psychiatry. 2008; 23(8):812-20. PMC: 2717612. DOI: 10.1002/gps.1983. View

20.

Feldman H, Jacova C, Robillard A, Garcia A, Chow T, Borrie M . Diagnosis and treatment of dementia: 2. Diagnosis. CMAJ. 2008; 178(7):825-36. PMC: 2267847. DOI: 10.1503/cmaj.070798. View