45 Family Members’ Perceptions of the Benefits of the Neuropsychological Evaluation

Abstract

Objective:

The objectives of this study were to investigate family members’ perception of the impact of the neuropsychological evaluation and subsequent feedback session on (1) caregiver understanding of the patient’s diagnosis and symptoms and (2) treatment planning, patient well-being, caregiver stress, and support utilization.

Participants and Methods:

Participants included family members of patients undergoing a neuropsychological dementia evaluation and subsequent oral feedback session at a midwestern university medical center by one of five neuropsychology providers. The average age of patients undergoing dementia evaluation was 73.4 (range = 52 - 92). Patients in the sample were categorized as having dementia (67%), mild cognitive impairment (24%), or no cognitive disorder (9%), with 46% of the sample suspected to have Alzheimer’s disease or mixed Alzheimer’s and vascular disease. Immediately following the feedback session, family members were provided a brief survey, $10 prepaid gift card to keep regardless of survey completion, and a stamped, pre-addressed envelope to return the survey anonymously by mail. A total of 200 surveys were disseminated and 127 (64%) were completed and returned. Family members completing the survey were most often the spouse (60.6%) or the child (29.1%) of the patient. Eighty-two percent of respondents identified as being the patient’s primary caregiver.

Results:

Family members were asked to rate their agreement to perceptions held both prior to and following the neuropsychological evaluation. Ninety-seven percent strongly agreed (81%) or agreed (16%) that the neuropsychological evaluation was helpful, and 95% strongly agreed (62%) or agreed (33%) that the neuropsychological evaluation would help the patient get better or more targeted care. Comparison using Wilcoxon signed-rank tests indicated that family members were significantly more likely to agree (p < .001) with the following beliefs after, as opposed to preceding, the neuropsychological evaluation: (1) the patient’s symptoms had been well addressed (z = -7.95), (2) I was explained the diagnosis (z = -8.12), (3) I am confident in my family member’s diagnosis (z = -7.88), and (4) I am more likely to use dementia-related community resources (z = -5.78). Additionally, family members nearly unanimously agreed or strongly agreed that, following the neuropsychological evaluation, their family member’s symptoms had been well addressed (98%), they were explained the patient’s diagnosis (98%), and they were confident in the diagnosis (97%). In instances where dementia was diagnosed, 91% of family members agreed/strongly agreed that they planned to use dementia-related community resources. Furthermore, a majority of family members reported that the neuropsychological evaluation positively impacted the patient’s psychological wellbeing (82%), caregiver stress (74%), caregiver interactions with the patient (76%), treatment plan (82%), and overall patient care (79%).

Conclusions:

Results indicate that family members of patients undergoing neuropsychological evaluation for suspected dementia perceive the neuropsychological evaluation as improving diagnostic understanding and confidence. Additionally, family members nearly unanimously agreed that the neuropsychological evaluation had a positive impact on treatment planning, patient well-being, caregiver stress, and utilization of supports.