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Table 3 Behaviours identified from all three sources

From: Appropriate disclosure of a diagnosis of dementia: identifying the key behaviours of 'best practice'

• Organise a private, quiet, comfortable location
• Schedule ample time
• Establish a trusting & supportive relationship with the patient
• Identify the most appropriate approach to disclosure based on knowledge of the patient and family
• Identify informal support available for the patient after disclosure
• Identify formal support available for the patient after disclosure
• Prepare the patient in earlier consultations
• Break the news over a series of contacts
• Discuss ahead of time how much information the patient would like about diagnosis and prognosis
• Respect the patient's right (not) to know
• Negotiate the presence of a relative with the patient
• Establish the patient's perceptions about their symptoms
• Give information step by step according to the patient's ability to cope with it
• Use terminology carefully as a way of getting information across without telling patients what they don't want to hear
• Check understanding frequently
• Be direct in disclosing the diagnosis
• Explicitly name the illness
• Avoid the use of technical terminology or medical jargon
• Discuss how the person's current problems may progress in the light of the probable diagnosis
• Provide an opportunity for the patient to absorb and emotionally process the information
• Create time and space for the individual to explore what the diagnosis means to them
• Provide an opportunity to discuss the diagnosis again, answer questions & clarify matters
• Repeat or reinforce information as required
• Document the information given and to whom
• Identify further medical and social care pathways
• Ensure information is consistent across professionals
• Provide (written) information on practical & emotional support available from health & social care services
• Provide (written) information on practical & emotional support available from voluntary organisations
• Identify the (practical) implications of the diagnosis
• Disclose all the treatment options (including no treatment)
• Do not impart too much information in one session