title: Communication problems between dementia carers and general practitioners: effect on access to community support services.
abstract: OBJECTIVE
  To investigate the circumstances that led general practitioners to refer dementia sufferers and their carers to community support services.
  
  
  METHODS
  Qualitative study using semi-structured interviews, carried out between 1 September 1999 and 30 April 2000.
  
  
  METHODS
  21 live-in carers of patients with dementia referred for the first time to a Western Australian metropolitan Aged Care Assessment Team, and 19 of their referring general practitioners.
  
  
  RESULTS
  Most referrals occurred after the carers had been experiencing carer stress, and were precipitated by crisis situations. Carers failed to discuss their difficulties with the referring GP for a variety of reasons, including the belief that they should cope because it was their duty. The doctors found it difficult to know how the carers were coping or when to intervene, and some carers tended to resist their attempts to help. Time constraints were a significant problem for both groups.
  
  
  CONCLUSIONS
  Attitudinal barriers in both carers of patients with dementia and GPs, combined with time constraints, often lead to inadequate assessment of carer problems. While it is important that strategies to improve communication between carers and GPs are developed, it would be sensible for GPs to assume that dementia carers are at risk of carer stress and should be encouraged to use community care services.
authors.affiliation: Department of Medicine, University of Western Australia, Perth, Australia. dbruce@cyllene.uwa.edu.au
authors.forename: David G
authors.initials: DG
authors.lastname: Bruce
authors.forename: Glenys A
authors.initials: GA
authors.lastname: Paley
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Underwood
authors.forename: David
authors.initials: D
authors.lastname: Roberts
authors.forename: Duncan
authors.initials: D
authors.lastname: Steed
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003142:Communication; D019058:Community Networks; D003704:Dementia; D005194:Family Practice; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D014904:Western Australia