| 149 6 Introduction Receiving a dementia diagnosis greatly affects people with dementia and their loved ones (1). How the diagnosis is disclosed can affect responses, people with dementia and close family and friends often respond with sadness, shock, anxiety, depression, or shame (2, 3). People with dementia may experience selfstigma, which can negatively impact their wellbeing (4, 5). Caregivers (usually spouses and children who provide informal care) can experience anger, devastation, and grief (6-8). A diagnosis may also be beneficial as it provides relief and validation after a period of uncertainty and enables caregivers to act despite experiencing grief and loss (9, 10). It may confirm suspicions or explain changes that have been noticed and provide a sense of control (11). More practically, a diagnosis enables active planning for future care (12). People with dementia and caregivers utilize various strategies to cope with a diagnosis and make sense. Friends and family are important as emotional support and understanding can help people with dementia and caregivers navigate the emotional challenges of diagnosis, maintain emotional stability and contribute to their psychological wellbeing (13-16). Formal support can address various needs, including behavioral and psychological symptoms and caregiver support (17). Caregivers need emotional and psychosocial support from healthcare providers and early support could increase their selfmanagement capabilities (18, 19). However, support is not always utilized (20). Some people with dementia might be reluctant to share their diagnosis with those outside their immediate social circle, limiting their potential support (21). Complex healthcare systems are often a barrier to accessing formal support (22). People with dementia may struggle to identify information sources and translate generic dementia information to their personal circumstances (11). Signposting is sometimes lacking, people are unaware of available services or how to access them (23). Caregivers sometimes do not access services early after diagnosis as they may not acknowledge their own support needs due to difficulties in accepting the situation (24). Experiences of dementia diagnosis and support can differ between countries as these can be affected by national dementia strategies and guidelines (25, 26). Australia focuses on coordinated, inclusive support through care coordination and planning, quality of care and carer support (27). The Netherlands prioritizes
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