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Information from the new guidebook

October 25, 1999
Web posted at: 6:45 p.m. EDT (2245 GMT)

-- Patients with dementia may be "critically dependent" on others, cannot operate common appliances, frequently have problems finding words, dressing and performing complex tasks such as cooking a meal or balancing a checkbook. They may get lost in a familiar area and need hours to return home.


-- Tests to help assess mental impairment can include asking a patient to name the current date and the location; draw a clock face; count backwards from 100 by sevens or spell "world" backward; identify a wristwatch and pencil, write a sentence or copy a design.

-- Physical tests such as blood counts and neurological workups can help determine whether a person has dementia or delirium. Delirium, which can be caused by vitamin deficiencies and other problems, has abrupt onset of symptoms and usually is reversible.

-- While dementia is a disorder that progresses over years and is incurable, most dementia involves Alzheimer's disease. Certain drugs have been shown to provide some benefit in Alzheimer's patients.

-- Dementia sufferers can have behavioral symptoms, such as depression, sleeping disorders, anxiety or sudden outbursts of emotion. Treatments can include counseling, antidepressants and stress-reduction efforts. The guide says using restraints for patients "is rarely appropriate."

-- Caregivers usually are family members, mostly women. As a group, caregivers "are physically, emotionally and financially vulnerable and are often the `hidden patients."' Doctors can help by referring them to support groups, helping them understand and plan for changes as the dementia worsens, and by encouraging them to use "respite programs" such as adult day care so they can take time off.

-- Dementia patients may be at higher risk of abuse, ranging from neglect to beatings or theft of their money, and often are unable to report problems. Doctors should be alert for symptoms, such as bruises or unusual activity in bank accounts. Suspected abuse should be reported to protective agencies.

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