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  • Cited by 4
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    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Peel, Elizabeth 2015. Diagnostic communication in the memory clinic: a conversation analytic perspective. Aging & Mental Health, Vol. 19, Issue. 12, p. 1123.

    Witte, Michael M. Foster, Norman L. Fleisher, Adam S. Williams, Monique M. Quaid, Kimberly Wasserman, Michael Hunt, Gail Roberts, J. Scott Rabinovici, Gil D. Levenson, James L. Hake, Ann Marie Hunter, Craig A. Van Campen, Luann E. Pontecorvo, Michael J. Hochstetler, Helen M. Tabas, Linda B. and Trzepacz, Paula T. 2015. Clinical use of amyloid-positron emission tomography neuroimaging: Practical and bioethical considerations. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, Vol. 1, Issue. 3, p. 358.

    Passmore, Michael J. 2013. Neuropsychiatric Symptoms of Dementia: Consent, Quality of Life, and Dignity. BioMed Research International, Vol. 2013, p. 1.

    Karnieli-Miller, Orit Werner, Perla Neufeld-Kroszynski, Galit and Eidelman, Shmuel 2012. Are you talking to me?! An exploration of the triadic physician–patient–companion communication within memory clinics encounters. Patient Education and Counseling, Vol. 88, Issue. 3, p. 381.


Expectations, experiences, and tensions in the memory clinic: the process of diagnosis disclosure of dementia within a triad

  • Orit Karnieli-Miller (a1) (a2), Perla Werner (a3), Judith Aharon-Peretz (a4), Gary Sinoff (a3) (a5) and Shmuel Eidelman (a2) (a4)
  • DOI:
  • Published online: 12 June 2012

Background: Health communication studies emphasize the importance of addressing the needs and expectations of patients and families with the disclosure of grave medical conditions. However, little attention has focused on their expectations and experiences of the clinical encounters in diagnosis disclosure of dementia.

Methods: In-depth post-encounter interviews with ten patients and 17 companions from two memory clinics in Israel were analyzed using grounded theory. The analysis focused on identifying their expectations, their experiences, and their perceptions of the process and outcomes.

Results: Major differences exist between patients’ and companions’ expectations. Patients’ expectations were an expression of the lack of knowledge/understanding of the visit's purpose and of insight into the memory deterioration. Companions had more clear-cut expectations: some desired confirmation of the legitimacy and pertinence of their concerns about their relatives’ memory problem, whereas others hoped to allay their concerns. Patients’ dissatisfaction stemmed mostly from their perceptions of the process, communication, and outcome. Companions’ dissatisfaction stemmed from lack of information or of tailored follow-up processes for implementing recommendations provided by the clinic.

Conclusions: Our findings expose two main issues challenging fulfillment of the different and frequently opposing expectations of patients and companions. The first is a consequence of the multi-participant nature of the encounter and the second relates to the character and severity of the disease itself. The discordance between the expectations of the two participants generates conflicts that interfere with meeting their diverse needs within the encounters – with consequent disappointment. The implications of these issues merit consideration in the planning of dementia management.

Corresponding author
Correspondence should be addressed to: Orit Karnieli-Miller, PhD, Department of Community Mental Health, Room No. 1111, University of Haifa, Har HaCarmel, Haifa, 31905, Israel. Phone: +972-4-8288643; Fax: +972-4-8288723. Email:
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International Psychogeriatrics
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