Diagnosis and management of dementia in primary care at an early stage: The need for a new concept and an adapted procedure
Graduate studies at Western
Theoretical Medicine and Bioethics 20 (3):213-226 (1999)
|Abstract||Diagnosis of dementia in primary care is both difficult and important. The recommendations by several authors to improve the diagnosis of dementia by general practitioners are important, but insufficient. It is argued that perhaps the disease concept in itself is a cause of confusion for clinicians. Primary care physicians need an adapted procedure, gradually leading to the final diagnosis of dementia. It has to be a stepwise labelling strategy, using global descriptions and non-disease specific labels in the beginning, ending up with well-defined disease criteria. In this process, there is circularity: previous diagnoses have to be kept in mind because symptoms and signs may gradually change during the progression of the disease, leading to reconsideration of previous deleted options. To frame this properly, the primary care physician needs to adopt a broad frail elderly geriatric concept. Implementation of this concept not only helps the diagnostic process, but also stimulates the care for dementing patients and their caregivers. Relevant arguments for early diagnostic involvement of primary care physicians can be put forward on condition that a new concept, adapted procedures and adapted instruments are used.|
|Keywords||No keywords specified (fix it)|
|Categories||categorize this paper)|
|Through your library||Configure|
Similar books and articles
Stephen R. Latham (2011). The "Real-Life" Death Panel, Reformed. Hastings Center Report 41 (1):53-53.
Linda Clare (2002). Developing Awareness About Awareness in Early-Stage Dementia: The Role of Psychosocial Factors. Dementia 1 (3):295-312.
Piero Antuono & Jan Beyer (1999). The Burden of Dementia: A Medical and Research Perspective. Theoretical Medicine and Bioethics 20 (1):3-13.
Cees M. P. M. Hertogh, Marike E. de Boer, Rose-Marie Dröes & Jan A. Eefsting (2007). Would We Rather Lose Our Life Than Lose Our Self? Lessons From the Dutch Debate on Euthanasia for Patients with Dementia. American Journal of Bioethics 7 (4):48 – 56.
Ursula Naue & Thilo Kroll (2009). 'The Demented Other': Identity and Difference in Dementia. Nursing Philosophy 10 (1):26-33.
J. Vollmann (2001). Advance Directives in Patients with Alzheimer's Disease; Ethical and Clinical Considerations. Medicine, Health Care and Philosophy 4 (2):161-167.
Thomas Schramme (2007). The Significance of the Concept of Disease for Justice in Health Care. Theoretical Medicine and Bioethics 28 (2):121-135.
George G. J. Agich (1999). The Importance of Management for Understanding Managed Care. Journal of Medicine and Philosophy 24 (5):518 – 534.
Added to index2009-01-28
Total downloads8 ( #131,938 of 740,603 )
Recent downloads (6 months)1 ( #61,957 of 740,603 )
How can I increase my downloads?