Current Options for Treatment of Behavioral and Emotional Problems

4 Current Options for Treatment of Behavioral and Emotional Problems 

Many behavioral problems can complicate dementia, and these problems can strike at any phase of the illness. It is often this aspect of the illness that is most distressing to both the patients and their caregivers. Behavioral disturbance is the most frequent cause of hospitalization and long-term institutionalization for patients who would otherwise be at home with their families. Therefore, treating these behavioral problems not only provides emotional relief for dementia patients and their families but can also lower the tremendous economic burden of dementia. The key, as we have said before, is to control the behavioral disturbance without worsening the dementia. (See Table 10.6) 

Delirium. Anytime you notice a sudden decline in a dementia patient, you should suspect delirium. Any time you notice a drowsy, stuporous patient, you should suspect delirium. If you suspect delirium, immediately send the patient for a medical examination. 

The medical treatment of delirium includes finding and removing the cause of the delirium and controlling the behavioral consequences of delirium. When searching for the cause of delirium, your patient s physician will perform a thorough physical exam, will review the recent medical history, will review the current medications, and will order a battery of laboratory tests. Because medications can cause or contribute to delirium, any medications that are not absolutely necessary and can safely be discontinued (at least temporarily) should be stopped. 

While the medical evaluation is being performed, treatment may be needed to control the patient. A frightened, combative, confused patient is dangerous both to him/herself and those trying to help. Therefore, medication may be needed to calm 

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