Abstract
Targeted screening for dementia among older adults in primary healthcare has potential benefits such as better clinical outcomes and the opportunity to access services. Cognitive screening can be followed up by further diagnostic assessment to determine a diagnosis of dementia. Unfortunately, the rates of accepting further diagnostic assessment following cognitive screening are low. The objective of this study was to explore the caregivers' decision-making process regarding uptake of diagnostic assessment following positive screening results. A qualitative design was employed, and interpretative phenomenological analysis was used to analyze the data. Three major themes in caregiver decision-making were identified: gathering information, protecting the patient, and balancing obligation and convenience in caregiving. These findings suggest that the decision-making process involved effort to process information through observations of the patient and that caregivers emphasized quality of life.
Highlights
Dementia is a general term that describes cognitive impairment severe enough to impair daily functioning and results in significant cognitive decline and disability among older adults
Dementia is often undetected by physicians in primary healthcare [3, 4]
All caregivers engaged in this process of observing the patient and making comparisons irrespective of whether the decision was to accept or refuse diagnostic assessment
Summary
Dementia is a general term that describes cognitive impairment severe enough to impair daily functioning and results in significant cognitive decline and disability among older adults. Of 140 participants, 33 were identified at screening to have moderate or severe risk of cognitive impairment and were asked to follow up with further diagnostic assessment [34]. No research has examined the caregivers’ decision-making process for patients to follow up with diagnostic assessment following screening, and the IPA approach was chosen to explore the subjective experience of decision-making. Of 140 participants in a study by Lee et al [34], 33 were identified to have moderate or severe risk of cognitive impairment and were asked to follow up with further diagnostic assessment [34]. Data were collected via semistructured interviews with caregivers to explore the decision-making process regarding accepting further diagnostic assessment following screening. Using an idiographic IPA approach to data analysis, descriptive (focusing on the content of the narrative),
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