Session Title: Dementia-Breaking The Barriers Speaker Name: Nasseer Masoodi, MD, MBA, FACP Assistant Chair/Senior Consultant; Ambulatory General Internal Medicine Vice Chair (A) Clinical Informatics; Department of Medicine, Hamad Medical Corporation Doha, Qatar

Conflict of interest declaration None to declare

Dementia-Breaking The Barriers! The diagnosis of dementia in primary care is perceived as a problem across countries and systems, resulting in delayed recognition and adverse outcomes for patients and their carers. Improving its early detection is thought to have multiple benefits to the patient, family, and healthcare system. In well established healthcare systems like UK, diagnosis rate has recently improved over the years to 69% In our Memory Clinic in Rumailah Hospital, we mostly see patients in later stages of disease.

Dementia-Breaking The Barriers! Alzheimer’s Association

What Are The Barriers! The most common reason, given by just over half of all respondents in a survey, is thinking the symptoms are normal signs of ageing. Others do not want to acknowledge the problems because they are fearful of the future. Denial by patient and/or family Social stigma associated with diagnosis Lack of awareness among heath professional https://cms.wiltshire.gov.uk/documents/s53980/Dementia%20Task%20Group%20update%20report%20-%20Appendix%201%20-%20Alzheimers%20Support%20report.pdf

Dementia-Breaking The Barriers! Real Life Scenario! 82 Year old Qatari gentleman seen at PHCC–he was found to have positive screen during our Community Dementia Survey He (Mr. I )attended PHCC along with his daughter in law (Mrs. S) on Feb 2018 Getting a collateral history from family is an essential part in the process of Dementia work up. Interview Process-Diagnostic

Dementia-Breaking The Barriers! Real Life Scenario! As the Interview progressed …… Patients DIL insisted “ He is just giving wrong answers” “He does not have any memory problems “ As we further informed the process of our assessment and progressed talking to the patient DIL further intervened and told him “ Don’t talk more –You will be diagnosed with Dementia and taken for electric shock treatment”

Dementia-Breaking The Barriers! Real Life Scenario! On the other hand –Patient kept looking at his DIL and stated “Doctor wants to know information –I want to speak to him” Further it was very apparent that DIL was adamant not to ask any further questions We requested if we could speak to his son, she stated there is no need to speak to anyone -“As she knows everything “ Refused to give us contact info of other family members For us, it was evident that patient has significant cognitive issues. We were not able to do a comprehensive assessment

Dementia-Breaking The Barriers! Let’s Pause here!! Do you see any issues here?

Dementia-Breaking The Barriers! 1. Is there awareness of dementia amongst people in general, and media in Qatar? 2. Do you think there are negative associations about people with dementia in Qatar? 3. What do you think can be done to reduce stigma? 4. Are persons with diagnosis of dementia avoided or treated differently because of the diagnosis? 5. Suggest a name for “Dementia awareness campaign” that is culturally acceptable?

Dementia-Breaking The Barriers! Conclusion Slides

Dementia-Breaking The Barriers! The Stigma Concerns about stigma, attributed by the patient or caregiver on receiving a diagnosis of dementia. This may develop as a result of a number of fears, from being labelled as having a mental illness, to loss of independence or autonomy. Lack of awareness Uninformed caregiver/family member

Dementia-Breaking The Barriers! Addressing Stigma! One strategy to eliminate stigma and enhance attendance is by educating society. There is an overall low level of understanding of the condition of dementia in the public and non-specialist domain which, alongside the stigma that might be attached, makes it difficult for people to talk about. There is also uncertainty about the boundary between normal ageing and cognitive impairment. "Raising Awareness and Understanding“.

Thank You Move to Case Scenario 2