Background: The increasing prevalence of dementia is expanding the role of primary care in its management. However, inequities exist in primary care for people with dementia, particularly with socioeconomic status. Individuals from socio-economically disadvantaged areas are underrepresented in research on this topic. Aim: To explore primary care experiences of people with dementia and their carers from socio-economically disadvantaged areas. Design and Setting: Qualitative interviews with people with dementia and their carers recruited from Index of Multiple Deprivation (IMD) quintile 1 or 2 postcodes. Method: We undertook 20 semi-structured interviews. Participants were purposively sampled by postcode via the Join Dementia Research Database. Participants were aged >18 years, with any type of dementia or were a carer for someone with dementia. Data were analysed using reflexive thematic analysis. Results: We identified four interrelated themes. These were: maintaining identity amidst impending loss, the paradox of healthcare support dropping away as needs increased, navigating the complex primary healthcare system, and uncertainty about where dementia healthcare sits within general practice. Views about the impact of socio-economic disadvantage varied. Some participants felt local resources, or individual social capital affected healthcare they received. Conclusions: Changes in primary care, including proactive contact, clearer communication of dementia-related care and consistent relationships could improve patient experience. Clarifying primary care's role in dementia management is essential, especially with proposed shifts towards primary care-led post-diagnostic support. Further work is needed to establish if these experiences are described by people with dementia across all social-strata or are specific to areas of socio-economic disadvantage.
Morris et al. (Fri,) studied this question.