17 Nov 2021Brazil
Mr. D would be entitled to a consultation with the general practitioner (medic) through SUS which provides universal healthcare that is free at point of access. However, it is unlikely that Mr. D would see a doctor by himself, he would need one of his children to take him to a medic consultation (regardless of being a consultation by the public or private health sector). Even in mid-size towns, general practitioners often do not have enough knowledge to diagnose dementia, so Mr. D could be at a later stage of dementia when diagnosis would formally be given (if any).
Mr. D would need to move in with his son or another family member to be assisted with his daily activities as no continuous care or support would be available for him at his own residence, unless he paid for it privately or via health insurance (the latter usually do not include day-to-day care).
Primary healthcare teams would provide visits for specific health needs, but long-term further care would need to be provided for by the family or privately. It is possible that in one of these visits, the primary care team would make a multidimensional assessment (to have a biopsychosocial diagnosis of Mr. D and identify his frailties) and develop a care plan to be performed together with his family. However, although this service is available, its implementation will depend a lot on the knowledge of the health team. Mr. D would probably become socially isolated and would not be encouraged to be independent.
It is very likely that Mr. D would experience stigma from neighbours or even from some family members as he could be excluded from meetings given to a possible “not socially accepted” behaviour. His son is already worried about what people may think of his father. Friends and neighbours may not be supportive and could judge Mr. D’s family for leaving him living at his own house, or in case they decided to pay for a long-term residential care home. Probably, a daughter or daughter-in-law would take responsibility over his care taking him to live with her and her family or moving in his house.