Swedish Clinical Professionals’ Perspectives on Evaluating Cognitive and Communicative Function in Dementia

Abstract

Objectives: This study investigated Swedish clinical professionals’ experiences of diagnostic pathways in dementia, focusing on the assessment of cognitive and communicative abilities. Methods: Interdisciplinary teams in Memory Clinics, General Practitioners in Primary Health Care, and Speech Language Pathologists were interviewed. The transcripts were analyzed using qualitative Content Analysis. Results: The study sheds light upon the perceived barriers and facilitators of good practice, e.g. time and clinical collaborations. Perspectives among professionals vary as to how informal and formal information and procedures are to be integrated and weighted. External factors (e.g. physical proximity of professions) have considerable influence on information availability, transmission, and diagnostic processes. Communication impairment does not emerge as a clinical priority. Conclusions: Published clinical guidelines notwithstanding, there is in practice no “gold standard” regarding diagnostic processes. Reorganization of services that impact feasibility of cross-disciplinary contact may negatively impact diagnostics. Clinical implications: Interprofessional collaboration is impacted by many factors, e.g. physical proximity and availability of specific professions. In order to optimize collaboration in dementia diagnosis, communication channels between professions need to be optimized. Additionally, making clinical impressions and “gut-feelings” explicit could contribute valuable information to the diagnostic process.