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
-- 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
-- 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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