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Advances in Psychiatric Treatment (2003) 9: 335-341
© 2003 The Royal College of Psychiatrists

What should we tell people about dementia?

Gill Pinner and Walter Pierre Bouman

Gill Pinner is a consultant psychiatrist for older people and Clinical Director of Mental Health Services for Older People for Nottinghamshire Healthcare NHS Trust, with an academic attachment to the University of Nottingham (Section of Old Age Psychiatry, Division of Psychiatry, University Hospital Nottingham NG7 2UH, UK). Her interests include research into ethical issues in dementia care, medical education and service development. Walter Pierre Bouman is a consultant psychiatrist for older people at University Hospital Nottingham. His research interests include sexuality in old age, psychopharmacology and service innovation.

This article reviews what we should tell patients and carers about dementia. The attitudes and views of patients, carers and peer groups are examined, as is the practice of doctors and other professionals working in dementia care. Factors influencing the decision to disclose the diagnosis of dementia, including the degree of certainty of the diagnosis, the degree of insight of the patient and the severity of the dementia are considered. Advantages, disadvantages and ethical issues of disclosure are discussed, as well as when or whether and how to disclose the diagnosis. Flexible guidelines regarding the process of disclosure are introduced.




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