General care and support
The most important thing is general care and support.
To a person with dementia, the world is a confusing and sometimes hostile place. So it is a great help to have people around them to help them understand what is going on, to take their time, and to offer emotional and physical support.
Cognitive stimulation and reality orientation therapy
These therapies involve activities designed to stimulate the person’s mind and remind them of who they are, where they are and what they are doing. These can be done by anybody.
This therapy uses a problem-solving approach and different strategies to try to change a particular behaviour, such as wandering or aggression. Behavioural therapy is usually provided by a carer or trained friend or relative.
This therapy focuses on dementia from an emotional rather than a factual perspective. Rather than trying to bring the person with dementia back to our reality, validation therapy advocates that it is more positive to enter their reality. This type of therapy aims to offer comfort and reduce distress.
Music can be used as a formal therapy or simply for enjoyment. It can also help in the management of difficult behaviours. Music therapy does not require a long attention span and it can also be a valuable trigger for reminiscing.
Reminiscence is a way of reviewing the past in a positive and rewarding way. Even if the person with dementia can’t speak, they can still get pleasure from being involved in reflections on their past. It can also be a means of distraction if the person becomes upset.
There are several medicines available in Australia to treat a variety of symptoms associated with dementia. These include medicines for:
- cognitive (thinking) symptoms
- agitation, aggression, delusions and hallucinations
- sleep disturbances.
If medicines are being considered, questions to ask the doctor include:
- What are the potential benefits of taking this drug?
- How long before we notice an improvement?
- How will we know if it’s not working?
- What are the known side effects?
- What should be done if there are side effects?
- What other medicines (prescription and over the counter) might interact with this medicine?
- How might this drug affect other medical conditions?
- Is the drug available at a subsidised rate?
Some of the symptoms listed above are termed behaviourial and psychological symptoms of dementia (BPSD) that can cause distress and harm to those affected by dementia. Sometimes a doctor may suggest use of a type of medication known as an anti-psychotic to manage BPSD.
The National Prescribing Service (NPS) advises that the use of anti-psychotic medication be reserved for the management during dementia care of more severe BPSD psychological and behaviour changes. Less severe BPSD can be managed in most cases without the use of anti-psychotic medication. For more information, talk to your doctor or visit the Choosing Wisely Australia website.
The consent of a person with dementia is needed for any treatment offered.
Expert advice - dementia treatments
Living with dementia can be difficult, but there are ways to treat and manage it. Watch the video below and learn about the treatment options for dementia. These include physical exercise and medication and how they can help slow dementia's progression or manage its symptoms.
A person with dementia will need more care as time goes by. It's a good idea to establish one person as the coordinator of that care early on. They could be a health professional, a social worker or a relative or friend.
It is also a good idea to have that person develop a care plan. This plan is a way of making sure the right care and treatment is offered at the right time.
It is wise to plan early for the future.
A person with dementia can delegate the management of their affairs to someone they trust through a power of attorney.
They can also draw up an advanced care directive which states their treatment preferences in case they are unable to give consent to treatment at a later stage.
Last reviewed: November 2016