Infections that last

August 2009


Dementia – who cares?

A comparison of community needs and primary care services

Volume 38, No.8, August 2009 Pages 642-649

Fiona Millard

Bernhard Baune


Health professionals have varying levels of knowledge about, and interest in, providing dementia services. This article compares patient experiences in dealing with dementia with the perceived role of health care providers in providing dementia care.


Qualitative data from interviews of patients with dementia and their carers was compared with quantitative data from health professional surveys, where health professionals described their knowledge of dementia and their attitudes toward, and roles in, management.


Patients often notice dementia symptoms before their general practitioner and seek diagnosis and support. Not all GPs wish to provide dementia services and many are unaware of the benefits of early diagnosis and dementia care guidelines. Dementia forums attract older health professionals, suggesting younger members are less engaged in dementia care. Older patients tend to consult with older GPs, but older GPs are less aware of dementia diagnosis and management guidelines.


Patients turn to their GP for help with dementia but may find most benefit from the assistance and advice of people who have already negotiated the pathways to care. Health professionals who fail to investigate patients presenting with dementia symptoms can delay diagnosis, denying patients and carers early intervention that could improve quality of life for both patient and carer.

Although there is clear evidence that early diagnosis of dementia is beneficial to patients, their carers,1,2 and the health system,3 this diagnosis is often delayed, resulting in less than optimal management that impacts on the quality of life of the sufferers.4 The symptoms of dementia may develop slowly and may remain untreated until a crisis arises, so the general practitioner needs to be alert to the warning signs if the diagnosis is to be made in a routine consultation.5 Symptoms suggestive of dementia do not always trigger further investigation, so the diagnosis may remain unconfirmed.6 Many doctors feel that unlike other diagnoses, for which a range of treatments are known to be beneficial, little can be done to help those with dementia.7 General practitioners may lack training in dementia, especially older GPs whose training preceded modern treatments for the disease.8 Nurses and GPs who receive dementia education may increase case finding activities,9 working together as a team to achieve an initial diagnosis and applying evidence based strategies in ongoing management.10 General practitioners are likely to be more actively involved in dementia care when they have access to specialist dementia services and support.7

Download the PDF for the full article.


Yes     No

Declaration of competing interests *

Yes No

Additional Author (remove)

Yes No






Competing Interests: 

Your comment is being submitted, please wait


Download citation in RIS format (EndNote, Zotero, RefMan, RefWorks)

Download citation in BIBTEX format (RefMan)

Download citation in REFER format (EndNote, Zotero, RefMan, RefWorks)

For more information see Wikipedia: Comparison of reference management software