Dementia is a condition in which memory is impaired along with other cognitive functions. There are various types of dementia, but there are several underlying principles of treatment that can be applied to all patients. Non-medication interventions are the cornerstone in the treatment of dementia.
Living Situation
The first step in treating dementia is deciding where the patient will live. The patient must participate in this decision to the degree that he can. Since dementia progresses, the living situation can be expected to change over time. Planning for the future is essential. If the patient has mild dementia, living independently in his own home with the help of a caregiver is often the best plan. The home is the comfort zone, more so for a person with dementia than for anyone else. When memory is impaired, it's important to stick to what's familiar. When dementia advances, it often becomes necessary to take the patient into the family's home, or if that is not a viable solution, to move him into assisted living or a nursing home. An occupational therapy assessment can help in this decision by determining how much assistance a person requires with tasks of daily living.
Safety Interventions
The patient's access to his previous activities may have to be limited to reduce the danger to himself or others. An assessment of his capacity to drive safely is essential. Car keys may have to be taken away and his drivers license revoked. Access to a kitchen may be dangerous and may have to be limited, which also can be determined by an occupational therapist or by family reports about the patient's behavior. Guardrails at night can prevent falls. Safety rails should be installed in the bath. The floor should be cleared of obstacles. A light should be within easy reach, and a nightlight should be installed.
Activity
Noise and unfamiliar people are confusing to the person with dementia. Even mild stress can provoke anxiety. On the other hand, keeping active, both mentally and physically, will enhance the patient's general sense of well-being, relieve stress and reduce the risk of medical complications such as falls by helping maintain muscle strength and balance. Mental stimulation and a sense of connectedness are essential for any person, and the patient with dementia is no exception.
Nutrition
Patients with dementia are at risk for dehydration and malnutrition. They may not be able to obtain water on their own. They may lose their sense of hunger and even thirst as dementia progresses. Swallowing may become impaired and the type of foods eaten may need to be adjusted accordingly.
References
- Mayo Clinic: Dementia
- "Kaplan and Sadock's Comprehensive Textbook of Psychiatry"; Virginia Sadock and Ruiz Pedro; 2009
