Article Figures & Data
Tables
- Table 1.
Strategies for disclosing a diagnosis of dementia: The diagnostic disclosure should not be a one-time event. Clinicians should aim for an evolving and dynamic process, including predisclosure preparation; timely, individualized, honest, and sensitive disclosure; and educational and supportive interventions after disclosure.
DIMENSION STRATEGIES Predisclosure preparation Develop a rapport and explore knowledge, beliefs, and perceptions
Develop insight into patient and family needs
Respect autonomy: ensure meaningful involvement of the PWD by asking questions such as “What do you think caused the change in your memory and thinking?” or “What do you suspect the results of our testing might show?”
Help develop insight: explore discrepancies in knowledge and reduce gaps in understanding
Titrate information: consider background, level of knowledge, cognitive ability, and emotional readiness
Meeting information needs Maximize comprehension using careful wording, “talk-back” approach, and written information
Provide comprehensive information including diagnosis, areas of uncertainty, expectations and treatment options, and community resources
Follow up after disclosure to review information provided, clarify goals and expectations, and reinforce linkages with community services
Meeting emotional needs Explore emotional reactions
-There might be a range of emotional responses to diagnosis
-The PWD might have difficulty processing information and expressing emotions right away
-Pay attention to cues and reflect back to the patient: “I imagine this is difficult news” or “You seem to be quite shocked by the news.” Silence is a common reaction to the shock of hearing the diagnosis
Respond to emotions in an empathic manner
Foster a sense of hope and meaning
Be positive, but avoid the temptation to minimize seriousness
-Tell the PWD that many aspects of “self” and brain function are preserved until later stages
-Encourage a proactive response to diagnosis and timely future planning but reassure the PWD that decline is rarely rapid and there is time to adapt to the illness
-Reaffirm your commitment to ongoing care
PWD—person with dementia.
Adapted with permission from Aminzadeh et al.11
