Giving patients bad news is difficult. And when that bad news happens to be an Alzheimer's diagnosis, it's so challenging that most doctors avoid doing it, according to report released Tuesday by the Alzheimer's Association.
Only 45 percent of Medicare patients diagnosed with Alzheimer's disease or their caregivers reported they were told the diagnosis by a healthcare provider, according to the association. When the analysis takes out diagnoses given to caregivers, the figure dropped to 33 percent, noted an article in U.S. News & World Report. In contrast, 90 percent of Medicare patients with cancer said they were told their diagnosis by a doctor.
"How is it OK that someone is going into their doctor's office and not getting a diagnosis for a fatal, progressive disease?" Beth Kallmyer, vice president of constituent services at the Alzheimer's Association, wondered in the magazine.
One of the reasons doctors may avoid telling patients they have Alzheimer's is a perception that the news will do more harm than good, as there's little that can be done to soften the blow of learning one is suffering from a degenerative and incurable disease of the brain. Thus, doctors often fear the emotional reaction the diagnosis may cause, Keith Fargo, director of scientific programs at the Alzheimer's Association, told NPR.
But according to Pierre Tariot, M.D., a geriatric psychiatrist who directs the Banner Alzheimer's Institute in Phoenix, it can be even more upsetting for patients experiencing cognitive symptoms to not know why they're occurring. Once told the truth, "people are relieved, not distressed," he told NPR. "They're relieved to have somebody who knows what's going on and gives a message of at least some hope ... a message that, 'We will stand by and navigate this process with you.' "
Getting the correct information can also cue patients and their family members to make plans for future care, but patients in the early stages of the disease, when they still have the mental ability to make such decisions themselves, are even less likely to be told their diagnosis than those with more progressed illness, according to the report.
Other reasons doctors may not tell patients they have the disease include diagnostic uncertainty, time constraints, lack of support, communication difficulties, patient or caregiver wishes and stigma, noted U.S. News & World Report. The industry needs more resources and education to help medical providers in presenting the diagnosis to patients, according to the Alzheimer's Association.
To learn more:
- see the report
- read the article in U.S. News & World Report
- chec out the story from NPR