Biomedical subjects

Guy Frenette

Publications and source records attributed to Guy Frenette.

4 recordsLinked to original sources

PubMed2003

Sad but true: your father has dementia. An approach to announcing the diagnosis.

OBJECTIVE: To show that family physicians have an important role in caring for patients recently diagnosed with dementia. SOURCES OF INFORMATION: This article is based on the authors' clinical experience and on the recommendations of the Canadian Consensus Conference on Dementia. MAIN MESSAGE: The authors touch on themes often ignored in the literature, such as issues surrounding the first time patients and their families are confronted with a diagnosis of dementia. We show the advantages of informing patients of the diagnosis and refute arguments for keeping it a secret. We then describe aspects of anticipatory counseling, which should begin as soon as the diagnosis is made: natural evolution of the disease, risk factors, power of attorney, driving, medical follow up, risks of polypharmacy, resources for psychological support of caregivers, and orientation to community resources (for helping patients remain at home). CONCLUSION: Physicians must inform patients and their families of a diagnosis of dementia and provide anticipatory counseling so that families can prepare for the long-term responsibility of caring for someone with this disease.

Automobile Driving↗

PubMed2003

[It is sad, but it is true: yes, your father has dementia...].

In the coming years, an increasing number of patients will be told by their family physician during a visit to his office that they are suffering from dementia. Since it is primarily a clinical diagnosis, and as doctors will have to manage the discomfort and uncertainty associated with it (possibility versus probability of dementia), the doctor-patient communication skills will be at the centre of the relationship. There is still no cure for dementia. When and how should we tell the patient and his family about it? What are the pros and cons of formally telling the patient? People expect to hear the truth, and get useful information at the right time. They also look for a regular and trustworthy follow-up through the full course of the disease. Giving information to the patient and the family is of the utmost importance: risk factors, diagnostic features, things to expect, prognosis, treatment, legal aspects, driving license. Natural caregivers play a major role in keeping the patient at home with an optimal quality of life: they have their own expectations and must be given appropriate support and information by the family physician.

Aged↗

PubMed2003

[My patient has dementia, but so far, it is not that bad...].

Depression can be the first sign of dementia or can occur in the follow-up of a clearly demented patient. One must be able to distinguish symptoms of depression and dementia, and recognize depression superimposed on dementia in order to provide optimal treatment. Suicidal risk must be assessed, and major depressive episodes must be appropriately treated. Useful drugs to treat depression in demented patients are reviewed. At this stage of the dementing illness, the patient still needs medical attention for other medical problems, periodic health exams, other chronic conditions, etc. It is also important to address the issues of CPR and level of care, if it has not been done previously. Legal aspects must also be clarified at this stage. The patient's ability to consent or to make financial decisions must be assessed. Some objective criteria are suggested. At this stage of the disease, the family physician can really make the difference between a premature nursing home placement and a patient staying at home with his family.

Anxiety↗

PubMed2003

[The difficult years at home...].

Patients suffering from dementia are at risk of developing some behavior problems during the evolution of the disease. Therefore, it seems important to rule out, from the outset, all physical, psychiatric, metabolic or pharmacological causes in every cognitively impaired patient with disruptive behavior. Before using any medication to treat the patient, it is advisable to attempt a non pharmacological approach. This article offers some advice to the benefit of the caregivers faced with their close ones' behavioral problems. In spite of the best non pharmacological approach, medication can be necessary in order to control and monitor the disruptive behavior. It is imperative to have a thorough knowledge of the psychotropic medications, their impact and possible side effects.

Antipsychotic Agents↗