Most Dementias progress slowly & they don’t have cure. But there are some medications available which may slow the progress of the Dementia. If diagnosed earlier the results & quality of life may remain very good. Person may remain independent for long. Also we have to find if any treatable condition like vitamin deficiency, hypothyroidism, depression, tumor, etc. is there to treat it.
There are number of Medications available e.g.
This is Acetylcholinesterase inhibitor. It is having very good results & can slow the progress of dementia. Others in this class are Rivastigmine & Galantamine.
It’s another drug used in combination with donepezil or as a monotherapy. It reduces cyto toxicity by acting on Glutamatergic (NMDA) receptors. Its also showed efficacy in slowing the progress of Dementia.
Both of these drugs may reduce the Behavioral symptoms of dementia effectively.
These drugs are used to reduce the behavior of an aggressive patient. But at Jagruti we don’t recommend them as they may cause more side effects as falls, sudden deaths & increased morbidity & confusion in patients.
Usually they are used to treat the depression associated with Dementia.
Psychosocial Intervention does not slow down the progression of Dementia but are helpful in managing the symptoms.
It includes various activities & exercises designed to improve memory, problem solving skills & language ability. These can be used to reduce aggression, improve communication, improve eating habits, to reduce incontinence etc.
It’s based on more emotional than factual things. Always there is some reason is there for any behavior of the patients. Ex. We have a patient Dr Potnis, she always asks when is my father coming to take me, although her father expired 20yrs back we have to tell her that he will come tomorrow or we have talked with him just now he will come. Immediately her behavior gets stabilized for some time. If we tell her that he is expired then she will get agitated & get unmanageable.
In this case we acknowledged her concerns & she got relieved for some time. Such therapy is used to divert the patient to another conversation.
These therapies can be used in various difficult behaviors of a patient. E.g. If a person is having symptom of wandering, we can engage him in some activities so he will be occupied & his symptom will reduce. Also aggression can be reduced using these techniques.
We are using various psychological interventions to reduce their challenging behaviors without using antipsychotics. A lot of time there are unmet needs, e.g. hunger, thirst, bowl bladder calls, some things they want. We have to carefully observe the patients & respond accordingly.
Its important issue, as many have difficulty in understanding & accepting the fact that their loved ones are having Dementia. We have to address care givers burden. Many people are having depressive symptoms & helplessness. Supportive therapies work for them or respite is another good example to reduce their burden.