If you are caring for a person with Alzheimers’ dementia, you are probably seeing a number of behavioral changes that are difficult to understand and challenging to respond to. These are sometimes called “neuropsychiatric symptoms,” and they span the spectrum from apathy and depression to wandering, disinhibition, irritable verbal onslaughts, agitated pacing, and hallucinations. Physicians sometimes have success in managing these symptoms by prescribing medications to address anxiety, restlessness/agitation or psychosis. Studies are ongoing and there’s an excellent article about them by Jeffrey L. Cummings, M.D. in the Spring, 2016 issue of AFA Care Quarterly.
Non-pharmacologic interventions are the province of behavioral therapy. Caregivers can learn what triggers an agitated response and can avoid those triggers; they can learn to engage the patient in activities which increase socialization and stimulation while avoiding an increase in the patient’s confusion or distress. Each patient is of course unique, and a caregiver would be wise to keep notes of behavioral changes, stimuli and triggers, as well as what responses seem effective and which just made things worse. This is crucial information for the physician, as well as for other people who will be caring for the individual.
If your loved one needs to be placed in a nursing home, a full medical report is requested and it is important to discuss these behavioral issues as you work with the staff to develop the individualized care plan. The Nursing Home Resident’s Bill of Rights and federal Medicare and Medicaid laws require a skilled nursing facility to “provide services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, in accordance with a written plan of care.” See 42 USC 1395i-3(b). It has to be an individualized plan. You will be helping the staff to do the best job for your loved one if you share with them what you know about him or her.
We advocate for nursing home residents in care planning meetings. For elder care advice and representation, call us at … 732-382-6070