A survey of 55 geriatric psychiatrists and geriatricians published in 2000 found that only 40% regularly tell patients with Alzheimer's disease of their diagnosis. Another study found that 95% of of doctors regularly informed patients of a terminal cancer diagnosis while only 39% revealed a dementia diagnosis. This all seems to contradict what most patients and caregivers think: 92% of patients in one study with mild dementia wished to be informed of their diagnosis, and 72% of caregivers in another study felt that patients should be told. In fact, some evidence suggests that most patients and caregivers do just fine psychologically after being told the diagnosis. while coping with the grief of a loved one's Alzheimer's diagnosis my be traumatic, learning to deal with that grief will undoubtedly benefit both the caregiver and the patient.
So why are doctors so reluctant to communicate a diagnosis of dementia? Of 10 factors that influenced a doctor's decision in a survey, the top three were certainty of a diagnosis, the patient's wish to be told, and the patient's emotional stability.
My feeling is that while there are certain individuals who would be severely distressed if they were told they had Alzheimer's disease, in general we should err on the side of letting people know what we think. If people aren't told then no plans can be made, and some patients might want to enroll in a clinical trial to help themselves and future patients. What do you think? Please comment .