Breaking the bad news: What do psychiatrists tell patients with dementia about their illness?

Consultants in old age psychiatry were sent a questionnaire concerning their practice in informing dementia patients and their carers about the diagnosis and prognosis. The results showed a wide variation in practice. Carers almost invariably were told of the diagnosis. Patients with severe dementia were almost never told. There was more of a tendency to tell moderately affected sufferers but for patients with mild dementia practice was variable. There was a significant difference between all categories of dementia and the carer category for both diagnosis and prognosis giving. Informing patients of diagnosis differed from informing of prognosis only in the mild dementia category, with the tendency to give diagnosis more frequently than prognosis. Carers were also given diagnosis more frequently than prognosis. The article discusses some of the issues involved in giving information on diagnosis and prognosis to patients with dementia.