Family physicians and dementia in Canada: Part 2. Understanding the challenges of dementia care.

Objective: To explore the challenges Canadian family physicians face in providing dementia care.

Design: Qualitative study using focus groups.

Setting: Academic family practice clinics in Calgary, Alta, Ottawa, Ont, and Toronto, Ont.

Participants: Eighteen family physicians.

Methods: We conducted 4 qualitative focus groups of 4 to 6 family physicians whose practices we had audited in a previous study. Focus group transcripts were analyzed using the principles of thematic analysis.

Main Findings: Five major themes related to the provision of dementia care by family physicians emerged: 1) diagnostic uncertainty; 2) the complexity of dementia; 3) time as a paradox in the provision of dementia care; 4) the importance of patients' families; 5) and familiarity with patients. Participants expressed uncertainty about diagnosing dementia and a strong need for expert verification of diagnoses owing to the complexity of dementia. Time, patients' family members, and familiarity with patients were seen as both barriers and enablers in the provision of dementia care.

Conclusion: Family physicians face many challenges in providing dementia care. The results of this study and the views of family physicians should be considered in the development and dissemination of future dementia guidelines, as well as by specialist colleagues, policy makers, and those involved in developing continuing physician education about dementia.