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.