Attitudes of elderly subjects toward "truth telling" for the diagnosis of Alzheimer's disease.

This study expands on previous research regarding attitudes of older adults toward disclosure of the diagnosis of Alzheimer's disease (AD). Two hundred patients 65 years or older completed a questionnaire assessing opinions about being told the diagnosis of AD versus cancer. Most responded they wanted to be told if they had AD or terminal cancer (92% for AD, 86.5% for cancer, P = .06). Those with personal experience with AD were significantly less likely to want to know themselves if they had AD than were those without personal experience (P < .0001). A variety of reasons were given for wanting to be told the diagnosis of AD, including a small minority (1.7%) who would consider suicide. Although these results appear to support recent American Medical Association guidelines favoring disclosure of a dementia diagnosis, complex issues remain. Further research is needed to develop guidelines for physicians in disclosing dementia diagnoses that includes outcome studies of disclosure to patients.

What are patients and their families told about the diagnosis of dementia? Results of a family survey.

BACKGROUND: Controversy exists as to whether dementia patients should be told their diagnosis and prognosis. OBJECTIVE: This study examined the experience of patients and families when a diagnosis of dementia is given. METHOD: Fifty-seven family members from community dementia support groups answered a questionnaire regarding the diagnosis of dementia in a family member. RESULTS: Family members were significantly more likely to have been told the diagnosis and symptoms to expect in dementia than patients themselves. Half of the families felt they were not given enough information regarding dementia. Interestingly, the majority of family members believed patients should be told their diagnosis and prognosis yet about half had reported that informed patients had reacted poorly to being told their diagnosis and only about a third felt it was helpful to the patient. CONCLUSION: The results suggest physicians should better involve patients and their families in disclosing diagnoses and information regarding dementia. The results also suggest the current AMA guidelines to inform patients their diagnosis of dementia are inadequate to address the clinical complexities of this issue.