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Family physicians’ perspectives on care of dementia patients and family caregivers

Pam Orzeck, MSW and Lucy Barylak, MSW
Ms Barylak is Director and Ms Orzeck is a staff member at the Caregiver Support Centre in the Centre de Santé et Services Sociaux Cavendish in Montreal

Correspondence to: Dr Mark Yaffe, Department of Family Medicine, St Mary’s Hospital Centre, 3830 Lacombe Ave, Montreal, QC H3T 1M5; telephone 514 734-2676; fax 514 734-2602; e-mailmark.yaffe{at}mcgill.ca

OBJECTIVE To identify factors that facilitate or impede family physicians in ambulatory care of patients with dementia and the family caregivers of such patients.

DESIGN Explanatory qualitative analyses of focus group discussions.

SETTING Large, medium, and small urban; suburban; and rural family practices from various regions of the province of Quebec.

PARTICIPANTS Twenty-five family doctors whose practices had at least 75% ambulatory patients; of these patients, an estimated minimum of 20% were 65 years old or older and at least 2% suffered from dementia.

METHOD Physicians were recruited by telephone to be paid participants in their regions in focus groups studying aspects of dementia care in ambulatory settings. Grounded theory and constant comparative methods were used to explore data from 3 French-speaking focus groups and 1 English-speaking focus group.

MAIN FINDINGS Physicians were 72% male, had a mean of 21.3 years in practice, and spent about 87% of their professional time in office practice. An estimated 38.7% of their patients were 65 years old or older, and 5.6% of these patients had Alzheimer disease or related dementias. Physicians were comfortable caring for these patients and their family caregivers but thought much of this care should come from support services offered elsewhere. Physicians admitted they had little knowledge of these services and had little interest in acquiring information about them. Government-run, community-based health and social service centres were the "black boxes" to which they referred patients and their caregivers for any form of help. Inconsistencies in the services offered by these centres were noted.

CONCLUSION While family doctors are seeking a more seamless form of interdisciplinary dementia care, a large amount of that care comes from support services about which physicians are not well informed and are not interested in learning.

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Diane Kelsall
CFP 2008 54: 963. [Full Text]  

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				S. Feldman The Referral Dance: Improving the Interface Between Primary Care Practitioners and Specialists Caring for Patients With Dementia American Journal of Alzheimer's Disease and Other Dementias, January 1, 2009; 23(6): 513 - 515. [PDF]