| 202 Main findings This thesis explores the perspectives of people with dementia, informal caregivers and healthcare professionals on the dementia diagnostic trajectory and post-diagnostic support. The journey to living well with dementia starts with seeking help for cognitive issues. This thesis found that preferences are key in guiding the decision-making process during the diagnostic trajectory. Healthcare professionals play a pivotal role in bridging the gap between diagnosis and support, especially effective when they engage in both aspects. However, significant gaps remain in post-diagnostic support, with a third of people with dementia and informal caregivers not being satisfied, highlighting differences in confidence and satisfaction between them. The experience of support following a dementia diagnosis varies, whereby the experiences of informal support networks and formal support through the healthcare systems are key. Inadequate formal support can exacerbate caregiver strain. The importance of seeking and receiving a diagnosis Receiving a dementia diagnosis is important as it is often a prerequisite for accessing support and enabling people to live well with dementia. There is much debate around the ‘ideal’ timing of a dementia diagnosis that facilitates the use and access of post-diagnostic support services. Proponents of early diagnosis argue that a diagnosis in the early stages of disease (sometimes prior to symptom onset) is beneficial as it enables early intervention, implementation of coordinated care plans, and better management of symptoms (1). However, others argue that this is not without risk as biomarkers may produce false positive results and an early diagnosis may negatively affect the quality of life of a person with dementia in the absence of cure (2). There has been a shift towards timely help-seeking, that is the person with memory complaints should initiate help-seeking at the right time for that person with memory complaints regardless of dementia stage or severity (3). As a timely diagnosis emphasizes the perceived need for support as central, it can adequately followed up with post-diagnostic support. A timely diagnosis is guided by the preferences of people with cognitive complaints. In Chapter 2 we identified that preferences were formed based on beliefs on the necessity and expected outcomes and the feeling of needing to do something about the symptoms. The need for timely diagnosis has also been underlined from
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