Dementia is characterized by the development of multiple cognitive deficits, including memory (deficits in learning new information or in recalling previously learned information) and at least one of the following: language (word retrieval difficulties, defects in understanding complex commands, loss of semantic knowledge), perception (problems in the identification of objects or in the recognition of familiar places), praxis (impairment in the ability to carry out complex movements), and executive functions (inability to plan and organize behavior). Calculation ability defects and conceptual difficulties are also commonly found. These deficits are usually progressive but in some cases are static. Dementia also comprises personality and emotional changes. Lack of awareness of the cognitive defects is frequently found. Psychiatric symptoms such as delusional ideation and hallucinations also might develop. As the disease progresses, these deficits impair the social and occupational functioning of the individual.
Dementia is a decline in mental functions that generally include short- and long-term memory and is often associated with changes in language, logical thinking, and personality. Most dementias are incurable. The term behavioral disorders describes a large group of symptoms that occur to at least some degree in all individuals with dementia, including delusions (present in 20% to 40% of dementia patients), hallucinations (10% to 20%), agitation (60% to 80%), aggression (30%), depression (40%), anxiety (15%), elation/euphoria (5%), apathy/indifference (40% to 60%), disinhibition (10%), aberrant motor behavior such as pacing (40%), insomnia (50%), and appetite/eating change (35%).
Living with dementia is emotionally painful and financially draining not only for the person who suffers from dementia but also for his or her family. Cost of caring for behavioral disorders in people with dementia accounts for more than 30% of total cost of caring for people with dementia. Although behavioral disorders can be life threatening, there is reason to be optimistic. The person suffering from dementia and his or her family can learn about ways to prevent or reduce agitation and other behavioral symptoms with simple, low-tech, nondrug interventions. There are also medicines that can help. Early diagnosis and treatment are keys to successful outcomes of behavioral disorders in dementia.
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Petitti et al (2008) found that the basic principle in helping people with dementia experiencing behavioral disorders is to adopt a philosophy of care that emphasizes quality of life. Personalized care plans build on the strengths of a person with dementia, enhance positive self-image, and promote autonomy.
The first step in treating behavioral disorders in dementia is to find and treat the cause. Behavioral disorders are often manifestations of unmet needs (e.g., food, hunger, thirst, toileting, discomfort, loneliness, boredom) of the person with dementia. Behavior disorders may in part be reactions to the actions of people around the person with dementia. For example, talking too loudly or too fast or contradicting the afflicted person's perceived reality might cause agitation. Misinterpretation of the person's behavior as intentionally malicious rather than as manifestations of a diseased brain not only may cause the caregiver distress but also may ...