SHOULD BEHAVIORAL APPROACHES BE FIRST-LINE TREATMENT FOR ALZHEIMER’S?
According to a study published March 2, 2015, in the British Medical Journal, a third of dementia patients in nursing homes and about 15% of dementia patients outside nursing homes were prescribed an antipsychotic. These medications carry a “black box” warning by the FDA, and their use has been shown to increase mortality.
Antipsychotics are given to treat symptoms of irritability, agitation, depression, anxiety, sleep disorders, aggression, apathy, delusions. An alternative approach is to identify the situations that trigger these problem behaviors. This takes more time. Caregivers should be educated, meaningful activities for the patient can be helpful, and simplifying tasks and establishing structured routines can also help. Interventions include de-cluttering the environment, using music or simple activities to help engage the patient, and using a calm voice instead of being confrontational. Caregivers should also get breaks from their responsibilities to avoid burnout and taking their frustration out on patients.
Jack Florin, MD
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