Within My Walls, I Escape Being Underestimated: A Systematic Review and Thematic Synthesis of Stigma and Help-Seeking in Dementia

Dementia-related stigma significantly influences help-seeking and affects the quality of care and support received by people with the condition. This review examines the impact of stigma on help-seeking among people with dementia and identifies key factors influencing this relationship. A systematic search across Web of Science, CINAHL, PsycINFO, PubMed, and Scopus identified seventeen qualitative studies that met the inclusion criteria. These criteria encompassed studies focusing on individuals aged 60 and older addressing public- or self-stigma and exploring help-seeking behaviors and related influencing factors. A thematic synthesis was employed to analyze the findings. The following five major themes emerged: reluctance to disclose the condition, internalization or rejection of stigmatizing beliefs, influence of family and community, attitudes of healthcare professionals, and lack of awareness in the broader society. Factors such as psychological decline, loss of autonomy, limited service access, peer support, and need for policy-level intervention were identified as central in shaping stigma. Findings related to the factors that influence this relationship indicate that stigma delays diagnosis and treatment, restricting access to adequate care. Both individual (e.g., autonomy, psychological well-being) and contextual (e.g., social networks, public policies) factors are crucial in moderating this dynamic. Targeted interventions addressing these dimensions are urgently needed to reduce stigma and facilitate timely help-seeking in dementia.