Experiences of primary care for people with dementia from socioeconomically disadvantaged areas: a qualitative study

Abstract 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 related to socioeconomic status. Individuals from socioeconomically disadvantaged areas are underrepresented in research on this topic. Aim To explore primary care experiences of people with dementia and their carers from socioeconomically disadvantaged areas. Design and setting Qualitative interviews with people with dementia and their carers recruited from deprived localities (Index of Multiple Deprivation 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: proactive continuity as a means of maintaining identity amid impending loss; the paradox of healthcare support falling away as it becomes needed more; challenges with accessing and navigating the primary healthcare system; and uncertainty around where dementia health care sits within primary care. Views about the impact of socioeconomic disadvantage varied. Some participants felt local resources, or individual social capital, affected the health care they received. Conclusion 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 socioeconomic disadvantage.