Currently there is no cure for either Alzheimer’s Disease or Vascular Dementia that can reverse damage that has already occurred in the brain. Treatment for dementia generally focuses on controlling current symptoms (such as agitation or depression) and preventing additional brain damage (for example, by controlling high blood pressure).
A number of psychological treatments and medications are useful in treating symptoms and enhancing e quality of life for all involved.
Behavioural symptoms can be treated non-pharmacologically, in ways that can help with adjusting to the initial diagnosis and forward planning, and in treating depression in early stage dementia.
Psychotherapy and psycho-educational intervention may assist carers, both to cope with caring for the person with dementia, and maintaining their own health and well-being.
Memory training and aids can assist a person in early stages of dementia to maximise their brain function and independence.
Dementia support groups can offer supportive networks and information about services.
Behavioural approaches are useful for difficult-to-manage behaviours like wandering, agitation and repetitive questions.
A general approach involves identifying a target behaviour and possible triggers and setting up a plan to modify the behaviour over time (including rewarding desirable behaviours).
Behavioural interventions maximise the use of retained skills , utilise weaknesses to promote enjoyable activities, ie poor concentration can make it easier to redirect a person to an enjoyable activity.
Interventions individually tailored to suit each person achieve the greatest success. Psychologists and other health professionals can help with this.
The ideal environment for a patient with dementia is one that is non-stressful, constant and familiar.
Sometimes things that may seem benign like television noise, can be upsetting to an individual with dementia who is having trouble making sense of the environment.
Minimise confusion by reducing choices, clutter, noise and light glare.
Provide activities that the person with dementia is comfortable with and enjoys; this may also reduce boredom and agitation.
Music therapy and pet-assisted therapy have also been successfully used with persons with dementia.
Medication is often paired with non-drug treatments for effectiveness.
Newer antipsychotic and antidepressant medications may prove effective in controlling symptoms such as hallucinations, delusions, anxiety, depression and physical aggression.
One class of drugs (cholinergic) includes medications that have a modest but definite effect on core symptoms of Alzheimer’s Disease, such as memory impairment. They provide measurable improvements in some individuals and may help improve memory and independent functioning in the short-term. However, the drugs do not appear to help all people, and their effects are time-limited.
What to do?
Be well informed. There are self-help organisations and groups for dementia sufferers and their carers. Talk with your GP about choices of drug treatments and resources in your area. The Alzheimer National Helpline offers information and support at 1800 341 341.
Watch Out for my book coming in January - Becoming Your Real Self: A practical toolkit for managing life’s challenges – Penguin Ireland