What is the role of the general practitioner towards the family caregiver of a community-dwelling demented relative? A systematic literature review

• Published in: Scandinavian journal of primary health care Vol. 27; no. 1; pp. 31 - 40
• Main Authors: Schoenmakers, Birgitte, Buntinx, Frank, Delepeleire, Jan
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 2009; Informa Healthcare
• Subjects: Adaptation, Psychological; Attitude of Health Personnel; Caregivers - psychology; Clinical Competence; Communication; Consumer Behavior; Cost of Illness; Dementia; Dementia - nursing; family physician; Family Practice; general practice; general practitioner; Home Care Services; Humans; Original; Outcome Assessment (Health Care); Physician's Role; Physicians, Family - psychology; Professional-Patient Relations
• ISSN: 0281-3432; 1502-7724
• DOI: 10.1080/02813430802588907

Objective. To identify the attitudes and perspectives of the family physician towards the caregivers of demented relatives and to describe the caregivers' satisfaction. Design. Systematic review. Subjects. The studied population consisted of dementia family and their general practitioners. Main outcome measures. Outcome measures were the generic tasks and skills of the general practitioner to improve home care from the perspective of the family caregiver. Caregivers were assessed on satisfaction regarding the care provided by their general practitioner. Results. The general practitioner is aware of his/her skills and limits in all aspects of dementia care and his/her role towards the family caregiver. They also acknowledged the importance of an adequate diagnostic process, but they felt uncomfortable disclosing the diagnosis to both the patient and the caregiver. They reported having more confidence in treatment matters than in diagnostic stages. Caregivers' reports on the attitude of their general practitioner in the diagnostic process were rated from helpful to poorly empathized. General practitioners found themselves to be highly involved in dementia home care, but caregivers rated their involvement to be insufficient. The lack of appropriate communication skills of general practitioners was also not appreciated by the caregivers. A lack of time and reward was considered by the general practitioner to be a major obstacle in dementia care. Conclusion. The key role of general practitioners as care providers and care planners is consolidated by the family caregivers' confidence in their skills. Clear guidelines from early diagnosis to adequate referrals should improve the ability of the general practitioner to support these time and energy-consuming home-care situations. Intervention studies addressing the gaps in the skills of the general practitioners in dementia home care management could be helpful in supporting the family caregiver.