A qualitative study with primary care providers: Barriers and facilitators in cognitive care planning

Cognitive care planning (CCP) is an effective service that supports aging adults with cognitive impairment and dementia and is reimbursable by Medicare; however, CCP remains underutilized by providers. We explored the experiences and perceptions of U.S. primary care providers regarding the implementation of CCP with older adults. Using a qualitative descriptive design, we conducted semi-structured teleconferencing interviews with nine primary care providers (work experience ranged from 8 to 38 years) actively providing care to older adults, including those with cognitive impairment and dementia. Conventional content analysis was used to analyze the data. Three categories of CCP barriers and facilitators emerged: (a) person-level factors, (b) condition factors, and (c) system-level factors. In addition to supporting previous dementia care in primary care studies, our study adds perceived facilitators and additional barriers to CCP implementation, expanding our understanding of ways to improve CCP in the older adult population.