Marie Janes

This qualitative study explores the significance of Pre-Assessment Counselling (PAC) in supporting timely diagnoses for people with dementia from the perspectives of clinicians. Reflexive thematic analysis was employed to analyse in-depth interviews with a multidisciplinary team of clinicians specialising in dementia care. Three themes were identified: (1) The centrality of people with dementia in their diagnosis journey, (2) The importance of candid conversations in building therapeutic alliances, and (3) Recognising people with dementia are more than their diagnoses. These themes elucidate the multifaceted aspects of PAC and its implications for well-being and engagement in dementia care. The findings underscore the significance of timely diagnoses for the well-being of people with dementia while highlighting the nuanced nature of diagnosis delivery. Moreover, they emphasise the importance of empowering people with dementia in decision-making processes and fostering resilience through comprehensive support. The clinical and research implications of PAC implementation in dementia care are discussed.

Dementia outcomes are better for those who receive early diagnoses, however, much stigma and fear surrounds help-seeking behaviours for dementia assessment, preventing intervention and support both for people with dementia and carers. Pre-assessment counselling for dementia involves the provision of a counselling service that occurs after approaching a clinician with cognitive or memory complaints, but before undergoing formal diagnosis of dementia. Pre-assessment counselling may help people with suspected dementia and their carers to understand and address concerns with dementia assessment and disclosure. Using PRISMA guidelines, four peer-reviewed publications involving clinicians, people with suspected dementia and carers and pre-assessment counselling were identified and reviewed. These studies used designs including random controlled trials, quantitative questionnaires, qualitative interviews and mixed methods research. The included papers ranged from 2007 to 2020. The impact of pre-assessment counselling is examined using content analysis. Themes including psychological adjustment for people with dementia, quality in delivering diagnoses for healthcare practitioners and the importance of including family members in the diagnosis journey were identified as the most significant impact of pre-assessment counselling. Limited literature exists to empirically evaluate the impact of pre-assessment counselling but the findings suggest that preassessment counselling provision is critical within the process of diagnosis.