Family physicians and dementia in Canada: Part 2. Understanding the challenges of dementia care.
OBJECTIVE
To explore the challenges Canadian family physicians face in providing dementia care.


METHODS
Qualitative study using focus groups.


METHODS
Academic family practice clinics in Calgary, Alta, Ottawa, Ont, and Toronto, Ont.


METHODS
Eighteen family physicians.


METHODS
We conducted 4 qualitative focus groups of 4 to 6 family physicians whose practices we had audited in a previous study. Focus group transcripts were analyzed using the principles of thematic analysis.


RESULTS
Five major themes related to the provision of dementia care by family physicians emerged: 1) diagnostic uncertainty; 2) the complexity of dementia; 3) time as a paradox in the provision of dementia care; 4) the importance of patients' families; 5) and familiarity with patients. Participants expressed uncertainty about diagnosing dementia and a strong need for expert verification of diagnoses owing to the complexity of dementia. Time, patients' family members, and familiarity with patients were seen as both barriers and enablers in the provision of dementia care.


CONCLUSIONS
Family physicians face many challenges in providing dementia care. The results of this study and the views of family physicians should be considered in the development and dissemination of future dementia guidelines, as well as by specialist colleagues, policy makers, and those involved in developing continuing physician education about dementia.
Women's College Hospital, 60 Grosvenor St, Toronto, ON M5S 1B6, Canada. nick.pimlott@utoronto.ca
Nicholas J G
NJ
Pimlott
Malini
M
Persaud
Neil
N
Drummond
Carole A
CA
Cohen
James L
JL
Silvius
Karen
K
Seigel
Gary R
GR
Hollingworth
William B
WB
Dalziel
D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003695:Delivery of Health Care / Q000592:standards*; D003704:Dementia / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D009864:Ontario; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011785:Quality Assurance, Health Care