Medication can’t always solve difficult dementia behaviors
The first solution that comes to mind might be behavioral medication, usually antipsychotics.
Unfortunately, these medications are typically not helpful.
We found a handy tip sheet created by the American Geriatrics Society (AGS) and Choosing Wisely that explains why antipsychotic medications for dementia aren’t recommended as the first choice for treatment – the risks often outweigh the benefits.
We explain why the AGS doesn’t generally recommend antipsychotic medications for dementia, share 6 non-drug ways for how to handle dementia behaviors, and explain when antipsychotics should be considered.
Why antipsychotic medications for dementia aren’t recommended
1. Antipsychotic drugs don’t help much
According to the AGS, studies have found that antipsychotic drugs usually don’t reduce challenging behavior in older adults with dementia.
2. Antipsychotic drugs can cause serious side effects
Doctors may prescribe antipsychotic drugs “off-label” for use in treating dementia behaviors, but the FDA has not approved them for this purpose.
The side effects can be very serious and the FDA now requires the strongest warning labels on these drugs.
Side effects include:
How to handle dementia behaviors: 6 things to try
In most cases, it’s best to try other approaches before using antipsychotic medications to manage challenging dementia behaviors.
1. Get a thorough physical exam and medication review
Having their doctor give a thorough exam and full medication review is a good first step to figuring out the root cause of difficult behavior.
Because people with dementia can’t communicate discomfort or needs, these behaviors may have a physical cause like constipation, infection, chronic pain, vision or hearing problems, or sleep problems.
2. Stick to a regular daily routine
If your older adult is losing their cognitive abilities, their world gets filled with more and more unknowns.
If their days aren’t structured, life can become even more stressful because they may not know what to expect next.
3. Help them exercise regularly
Regular exercise has many physical and mental benefits for all people, but can be especially helpful for older adults with dementia.
Exercise can slow cognitive decline, boost mood, burn off nervous energy, and improve sleep.
There’s even a home exercise routine that improves dementia symptoms. Get more exercise suggestions here.
4. Learn new communication skills
Something that’s less obvious is that we need to learn new ways to communicate with someone with dementia.
Their cognitive abilities are declining, which means that our “normal” methods may not work well anymore and could actually cause conflicts.
For example, certain natural actions may unintentionally cause your older adult to resist help.
Additional dementia communication tips:
Agree and use therapeutic fibs to go along with their reality rather than correcting them
Respond in ways that reduce repetitive questions before you get too frustrated
Use short, direct sentences to make understanding easier
Increase your ability to handle false accusations
5. Keep them entertained with engaging, no-fail activities
Boredom can also contribute to challenging behaviors. Everyone needs to have something to do and a way to have fun and feel successful.
Helping your older adult find activities that suit their current abilities and interests is a great way to boost their mood and self-esteem while reducing anxiety and agitation.
Activities for People with Dementia: 10 Fun, No Fail Ideas
6 Ways to Help Seniors with Alzheimer’s Keep Hands Busy
6 Alzheimer’s Sensory Activities Reduce Anxiety without Medication
Get more dementia activity ideas
6. Consider other types of medications
When antipsychotic medication may be needed
There may be situations where antipsychotic medications may be necessary.
If other approaches haven’t worked
Your older adult is severely distressed
They could hurt themselves, you, or others
If an antipsychotic medication is used, use these tips for best results:
Start at the lowest possible dose and increase a little bit at a time – the goal is to find the minimum necessary dose to keep behavior manageable
Watch carefully to see if your older adult improves
Watch carefully for side effects
If the medication isn’t working or causes side effects, let the doctor know right away so they can come up with an alternate plan. Don’t stop or change doses without doctor approval.
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By DailyCaring Editorial Team
Image: LifeCare Advocates
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