title: Dementia early diagnosis: triggers, supports and constraints affecting the decision to engage with the health care system.
abstract: OBJECTIVE
  There is very often a lengthy delay between first noticing symptoms of dementia and making first contact with Health Care Professionals (HCPs). This article identifies influences on the decision to contact HCPs for the first time.
  
  
  METHODS
  Qualitative thematic analysis of 20 case studies of carer experience. Participants were carers of people who attended Memory Clinic services.
  
  
  RESULTS
  Key themes emerging were: triggers, supports and constraints. The analysis draws out the social nature of the decision to engage with the health care system, considering the negotiations that occur and the areas that are contested.
  
  
  CONCLUSIONS
  Constraints generate delays at several points during the journey from first noticing something may be amiss to making first contact with an HCP. Supports and Triggers legitimise carer's actions to contact HCPs for the first time.
authors.affiliation: Arc Research and Consultancy Ltd, Sheffield, UK. arc@breakfast.solis.co.uk
authors.forename: Tom A C
authors.initials: TA
authors.lastname: Chrisp
authors.forename: Sharon
authors.initials: S
authors.lastname: Tabberer
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Thomas
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Goddard
mesh_terms: D017028:Caregivers; D057210:Delayed Diagnosis; D003704:Dementia / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D036301:Qualitative Research; D013997:Time Factors