Treatment of Dementia
Treatment of Dementia
Dementia is a progressive condition that cannot be cured, but a number of treatments are available to slow down its progress and there are medicines available that are prescribed for improving brain function. They do not affect the underlying disease and only help some people who try them. Treatment together with the level of care and certain physical,mental and emotional and mental stimuli can result in some temporary improvements in some patients.
Management of Dementia
As we have found already that there is no complete cure or treatment for dementia,we can only manage the distressing symptoms of dementia. One of the prime concerns is to manage BPSDs (Behavioural & Psychological Symptoms in Dementia). BPSDs are Signs and Symptoms of disturbed perception, thought content,mood or behavior that frequently occur inpatients with Dementia” (International Psycho Geriatric Association- 1996). It can generate caregivers stress and burden. There are three components in dementia management.They are:
1. Managing the Person with Dementia:
Dementia needs to be understood as an interaction between psychological and neurological influences. The main focus of dementia must be on the person living with the illness. Knowledge of the person provides crucial clues to the understanding of difficulties experienced and responses made.
While we try to understand the person,we should know his characteristic behavioral symptoms, problems in independent living, problems arising in daily care, other medical problems, changes in mood, etc.
Possible intervention for persons suffering from dementia are:
a. Behavior oriented approaches-effective in reducing problem behaviors- Antecedent-Behavior-Consequences (ABC)Analysis.
b. Training in Daily living skills and help to teach news kills.
c. Therapeutic approaches like reminiscence therapy and stimulation oriented approaches by recreational and art therapies.
2. Managing the Family/Caregiver:
The majority of dementia persons are being cared for by their relatives. Especially Alzheimer’s disease makes high demands on the relatives given it is a slowly progressing disease with diverse aspects. This quite often puts care giving relatives under enormous psychological and physical pressure. Care giving of a person with dementia needs “36Hours a Day”. Coping with the distressing behavior problems of the persons with dementia is more stressful.
These they express through emotional effects such as anger, irritation, sadness, loneliness, anxiety, and tension. The inability to work or perform dual roles, no breaks from caring, feelings of loss and grief, little training and support, exhaustion and economic constraints are other issues faced by the caregivers. The possible interventions with care givers are:
a. Individual therapy to acknowledge ambiguity and re frame perceptions of relationships,
b. Psycho-education: Educative approach.
c. Behavioral Management strategies for problem behaviors and agitation.
d. Cognitive behavior therapy.
e. Family therapy to handle issues interfering with treatment or causing distress exploring available supportive networks.
f. Training in care giving.
3. Managing the environment:
We should work for a dementia friendly and dementia literate society,which is more sensitive to needs of people with dementia and their family. This should begin with sensitization starting at young age right fromhome and school. There should be more and more supportive system for dementia care.