Fluctuation of Symptoms of Dementia
DEMENTIA IS A COMPLEX BRAIN DISORDER. IT RESULTS IN BEHAVIORAL & PSYCHIATRIC PROBLEMS. TREATMENT REQUIRES MEDICATION & THERAPY, A PSYCHIATRIST TO DIRECT THE TEAM AND WORK WITH NURSING STAFF AND FAMILY
As illustrated above, psychiatric symptoms usually begin in the first year of the disease and progress, while gradual, is erratic. The level of agitation suggests the more severe symptoms. This usually occurs after 5 years, and is related to more severe psychiatric symptoms of paranoia, delusions and hallucinations. The patient is often fearful or embarrassed to talk to family members, and family members tend to dismiss what the patient says as ridiculous because of their lack of reality.
These symptoms can be controlled with a combination of medications in the form of mood stabilizers, anti-psychotic, anti-anxiety and anti-depressants as well as psychotherapy, behavioral management and frequent (rather than less) family contact. (Request and read handouts of what family and nursing staff can do).
In addition to, a minimal dose of medication, counseling is important to optimize and maintain activity and social involvement. This is beneficial because it encourages activity and prevents isolation which, in turn, can lead to a more severe progression of symptoms such as agitated behavior, uncooperativeness, aggression or other inappropriate behaviors.
In order to provide the optimum care, patients need to be initially seen one to three times a week to monitor the symptoms and determine the options. This is necessary until symptoms are stable and to detect if symptoms change or are exacerbated.