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Diagnostic Disclosure
Making the disclosure of a dementia diagnosis to the patient and family, taking into account the risk of depression, is essential and can be challenging for physicians. A qualitative study was conducted with 30 patients and caregivers to examine the disclosure process [1]. Based on the findings on this study, ten recommendations to improve the process of disclosure of dementia were made. They are as follows:
an overwhelming majority of patients and caregivers supported full disclosure. Gradual disclosure with upfront discussion of possibilities and giving information through the assessment process was the preferred method of full disclosure
professionals need to be prepared for the emotional response of the patient and caregiver
provide a non-threatening setup for the meeting, comfortable chairs, circle setup etc.
ensure caregivers are there for support and provide follow up as needed
ensure there are familiar providers/professionals who can establish a link with the patient during disclosure (i.e. in specialty settings)
the treating physician should be the person disclosing, other team members (e.g. nurse) can also play a major role during disclosure
use/show empathy, provide a balance of hope and realism
ensure enough information is provided, use plain language and avoid jargon
use diagrams or flow charts if possible, and provide a written summary of findings
offer resources and follow up for more information on disease process
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1. Byszewski A. Recommendations in dementia disclosure. Alzheimer's Association 10th International Conference on Alzheimer's Disease and Related Disorders; 2006 July; Madrid, Spain.
