Behavioral symptoms of dementia

Abstract

Behavioral symptoms of dementia are often more difficult to manage than consequences of cognitive impairment. They may lead to caregiver burn-out or need for institutionalization. It is important to distinguish two types of behavioral symptoms: those which occur when the patient is solitary and those which occur when the patient is interacting with others. When patients are solitary they may develop agitation or apathy; very often these symptoms alternate in the same patient. When the patients are interacting with their caregivers, they may resist their care efforts because they do not understand why they need the care. If the caregiver persists in providing care despite patient's resistiveness, the patients may defend themselves, become combative and their behavior may be called abusive. Behaviors labeled abusive are often the most difficult behaviors of nursing home residents to manage. Resistiveness to care, related to lack of understanding, depression, hallucinations and delusions, are strongly related to abusive behaviors. Presence of depressive symptoms and delusions is also related to abusive behaviors independent of resistiveness to care. Very few residents who understand others and are not depressed are abusive. Behavioral interventions preventing escalation of resistiveness to care into combative behavior and the treatment of depression can be expected to decrease or prevent abusive behavior of many nursing home residents with dementia. Therefore, antidepressants should be used initially when non-pharmacological interventions are not effective. © 2011 by Nova Science Publishers, Inc. All rights reserved.