Photo Credit: Jacob Wackerhausen

Joanna Paladino, MD, and colleagues identified four themes that may improve the delivery of a dementia diagnosis for clinicians, patients, and caregivers.

“The early detection and diagnosis of Alzheimer’s disease and related dementias are critically important to ensuring that patients and caregivers have access to effective care, treatment, and services,” Joanna Paladino, MD, says. “Yet sharing the news of a dementia diagnosis is hard, even for the most seasoned and experienced clinicians. The news evokes complex and challenging emotions for patients and caregivers.”

For a study published in Alzheimer’s & Dementia, Dr. Paladino and colleagues examined communication challenges and opportunities in delivering a diagnosis of dementia. The study explored “the nuanced diagnostic disclosure communication experiences of clinicians across specialties, as the diagnosis is a critical window of opportunity to improve patient and caregiver experience, care planning, and outcomes,” Dr. Paladino notes.

The researchers conducted semi-structured interviews with clinicians at three academic institutions, including one federally qualified health center. An interdisciplinary research team used rapid thematic analysis to generate preliminary themes that were identified.

Factors That Influence the Delivery of a Dementia Diagnosis

The 18 interviews conducted by the researchers identified four preliminary themes, including experiences of trauma, differences in communicating a dementia diagnosis versus others, the role of team-based communication, and barriers that impact effective disclosures.

“Given the gravity of the news, the main finding was that diagnostic disclosure requires careful, incremental communication strategies that center therapeutic relationships with patients and caregivers,” Dr. Paladino explains.

Enhancing the Communication Process 

These themes indicate that “a structured, psychologically informed communication framework for inter-professional teams may enhance the quality and reliability of the diagnostic disclosure communication process in dementia care,” according to the study results.

“Diagnostic disclosure is a process that involves creating a trusting environment for patients and caregivers to receive and adapt to the difficult news of a dementia diagnosis,” Dr. Paladino notes. “There are opportunities for communication interventions and skills training for clinicians in tailoring diagnostic communication to patient and caregiver needs, responding to emotions, and discussing prognosis in the face of uncertainty. It is also important to provide safe spaces for clinicians to reflect on their emotions related to challenging disclosure experiences and how that might impact their practice.”