Development of a model of help-seeking for dementia diagnosis by the person experiencing changes and family supporters

Objectives: This paper aimed to develop a model to describe help-seeking for dementia diagnosis. The practical model is intended to guide public health interventions to increase help-seeking. 

Method: The model was developed by our multidisciplinary team based on qualitative semi-structured interviews in English (n = 33) and Chinese (n = 8) with older people, people with dementia and carers. The model was also informed by systematic reviews on help-seeking for dementia diagnosis, theories of help-seeking and further iterated based on feedback from a co-design group (n = 10). 

Results: The model starts with changes which might be symptoms of dementia being observed by the person or family/friends and ends in dementia assessment. Model steps are (1) The person deciding that the changes represent a health problem; (2) obtaining support or confirmation from family/friends that the changes are a health problem; (3) deciding to seek medical help; and (4) persuading the GP to facilitate dementia assessment. The model applies to English and Chinese-speaking Australians, though there were additional barriers for Chinese speakers. There are personal, family, community and health system barriers at each step. 

Conclusion: Interventions to improve diagnosis of dementia might target public knowledge of dementia symptoms and benefits of a diagnosis, and general practice.