Family physicians' perspectives on care of dementia patients and family caregivers.
OBJECTIVE
To identify factors that facilitate or impede family physicians in ambulatory care of patients with dementia and the family caregivers of such patients.


METHODS
Explanatory qualitative analyses of focus group discussions.


METHODS
Large, medium, and small urban; suburban; and rural family practices from various regions of the province of Quebec.


METHODS
Twenty-five family doctors whose practices had at least 75% ambulatory patients; of these patients, an estimated minimum of 20% were 65 years old or older and at least 2% suffered from dementia.


METHODS
Physicians were recruited by telephone to be paid participants in their regions in focus groups studying aspects of dementia care in ambulatory settings. Grounded theory and constant comparative methods were used to explore data from 3 French-speaking focus groups and 1 English-speaking focus group.


RESULTS
Physicians were 72% male, had a mean of 21.3 years in practice, and spent about 87% of their professional time in office practice. An estimated 38.7% of their patients were 65 years old or older, and 5.6% of these patients had Alzheimer disease or related dementias. Physicians were comfortable caring for these patients and their family caregivers but thought much of this care should come from support services offered elsewhere. Physicians admitted they had little knowledge of these services and had little interest in acquiring information about them. Government-run, community-based health and social service centres were the "black boxes" to which they referred patients and their caregivers for any form of help. Inconsistencies in the services offered by these centres were noted. CONCLUSION; While family doctors are seeking a more seamless form of interdisciplinary dementia care, a large amount of that care comes from support services about which physicians are not well informed and are not interested in learning.
Yaffe
Mark J
MJ
Department of Family Medicine, St Mary's Hospital Centre, 3830 Lacombe Ave, Montreal, QC H3T 1M5. mark.yaffe@mcgill.ca
Orzeck
Pam
P
Barylak
Lucy
L
D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D010348:Patient Care Team; D010817:Physician-Patient Relations; D010821:Physicians, Family; D011320:Primary Health Care; D036301:Qualitative Research; D011792:Quebec