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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.

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