Dementia Care Action Plan Physicians and Nurse Practitioners Questionnaire

1. I am a _________________: *

nurse practitioner

family physician

specialist

other

If other, please specify: *

2. How prepared are you to communicate a diagnosis of dementia? *

3. What do you need to become more prepared to communicate a diagnosis of dementia (select all that apply)? *

more time with the patient

training in screening/diagnostic tools

training in communicating the diagnosis

general education on dementia

training in communicating with people with dementia and their families

other

unsure

If other, please describe: *

4. What information do you currently provide patients when you give a diagnosis (select all that apply)? *

referral to a counsellor or social worker

referral to the Alzheimer Society First Link Program

information on the Community Supports Program

information on mental health programs

information on medications

information on advance care planning

information on estate planning

other

none of the above

If other, please describe: *

5. How prepared are you with respect to managing the ongoing needs of your patients with dementia? *

6. What would support you in the medical management of your patients with dementia? *

education about dementia

resource materials about dementia

clinical practice guidelines

participation in interdisciplinary case planning for patients

ability to consult with specialists

information about community based supports

information about health system navigation

other

unsure

If other, please describe: *

7. Have you experienced any of the following gaps in supports and services for people living with dementia (select all that apply)? *

If other, please describe: *

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