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"Give me the knowledge, and I can do what I want with it, it's my right and my choice": Triangulated perspectives on the disclosure of young onset dementia
Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland.ORCID iD: 0000-0002-6854-8975
Department of General Practice, University College Cork, Cork, Ireland.
Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. School of Social Work and Social Policy, Trinity College Dublin, Dublin, Ireland; Centre for Economic and Social Research on Dementia, NUI Galway, Galway, Ireland.ORCID iD: 0000-0002-4196-6464
Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland.ORCID iD: 0000-0001-6840-0359
2023 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 22, no 8, p. 1757-1775Article in journal (Refereed) Published
Abstract [en]

Introduction

Receiving a diagnosis of young onset dementia is particularly distressing; the person under 65 years is often in employment, with financial commitments, young children, and an active social life. Some of the stress experienced by younger people experiencing cognitive changes can be reduced by an early and accurate diagnosis, but this is contingent on the timing of disclosure and a process which is sensitive and appropriate to the person. The study aim was to explore experiences of giving and receiving a diagnosis of young onset dementia, by triangulating the perspectives of the key parties involved.

Methods

A qualitative design was employed, using semi-structured interviews. Participants (N = 47) included people with young onset dementia (n = 10), family members (n = 12), and health and social care professionals (n = 25). Thematic analysis and triangulation enabled identification of overall themes across different participant groups.

Results

All participant groups agreed on key aspects of good disclosure practice, with two overarching themes: The optimal conditions for disclosure, and how best to disclose a diagnosis. Positive experiences of disclosure were prefaced on having the appropriate space and time; having a support person present; clearly labelling the diagnosis; providing appropriate information at the right pace. Other findings include recommendations for longer appointment times, offering additional support for young families, and for carers of people with atypical presentations (e.g. frontotemporal dementia).

Conclusion

Many people with young onset dementia had unsatisfactory disclosure experiences. Health and social care professionals should provide a 'pre-disclosure' appointment, elicit the amount of information the person may want at the point of disclosure of the diagnosis, balance truth and hope, provide contact details for follow-up, and overall be mindful of the individual in front of them. While young onset dementia may be a life-altering diagnosis, a disclosure meeting which is sensitively undertaken can increase the person's agency, coping ability, and ultimately empower them to live well with their diagnosis.

Place, publisher, year, edition, pages
Sage Publications, 2023. Vol. 22, no 8, p. 1757-1775
Keywords [en]
diagnosis, disclosure, young onset dementia, carer, healthcare professional, frontotemporal dementia, qualitative research
National Category
Geriatrics Nursing
Identifiers
URN: urn:nbn:se:hj:diva-62243DOI: 10.1177/14713012231191958ISI: 001038698500001PubMedID: 37505214Scopus ID: 2-s2.0-85166019571Local ID: HOA;intsam;898012OAI: oai:DiVA.org:hj-62243DiVA, id: diva2:1790187
Available from: 2023-08-22 Created: 2023-08-22 Last updated: 2023-12-12Bibliographically approved

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Cahill, Suzanne

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