PAGE 36 |
Additional services may |
highest needs ) and risks if funding is |
time providing care and support for |
Living ( SIL ) and Supported Disabil- |
weaknesses and strategies to miti- |
include psychology or counselling , |
denied . GPs can also maintain refer- |
patients with young-onset demen- |
ity Accommodation ( SDA ). An NDIS |
gate these . Executive deficits such as |
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social support , help with activities of |
ral networks with allied health and |
tia , which arguably may put them at |
plan should include provision for |
impairments in planning and organ- |
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daily living , speech pathology , physi- |
social care providers with exper- |
higher risk of adverse psychological |
these increased supports with each |
isation may be improved by struc- |
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otherapy and / or exercise physiology , |
tise in young-onset dementia . The |
wellbeing . |
annual review . The availability of |
ture and routine . Activities of daily |
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cognitive training and home support |
needs of a patient with young-on- |
Living with a parent who has |
suitable supported accommodation |
living , practical issues such as safety |
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( for example , cleaning and cooking ). Occupational therapy can support |
set dementia can change rapidly , and more quickly than the standard |
young-onset dementia can have a significant impact on the nor- |
is limited , so it should be discussed early and often to ensure placement |
in the home , cooking and cleaning and other functional tasks can be |
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the patient and carer to implement |
12-monthly NDIS review process . GPs |
mal development of a child . This |
can occur when needed . |
assessed by an occupational thera- |
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problem solving and accommodations . If the patient is employed or volunteering , disability support services can assist both the patient and |
play an important role in monitoring the needs and supporting the patient in accessing an earlier NDIS review where needed . |
includes an insecure attachment , because the affected parent is not available and the unaffected parent has assumed additional respon- |
MANAGEMENT
Multidisciplinary team care
WHILE there is currently no cure
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pist ( OT ) for adjustments and recommendations . These include home modifications , such as a bigger bathroom or toilet , and the addition of |
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the workplace to implement accommodations to prevent early work cessation . |
Family unit
Dementia occurring at a younger
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sibilities ; this may cause conflicts in the family . 49 Children often also take on caring tasks prematurely and |
for dementia , the management of young-onset dementia is complex and can be conceptualised from a |
rails , different carpet and equipment , such as shower chairs and wheelchairs . Speech therapy can |
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Those with dementia will at some |
age affects the entire family unit . |
have difficulty managing the range |
biopsychosocial perspective for the |
assist with language and swallow- |
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stage need to stop driving ; refer |
The individual with dementia can |
of responsibilities , their schooling |
individual and the family ( and argua- |
ing assessment and communication |
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patients for a driving assessment |
experience loss of identity and role |
and their developmental milestones . |
bly the community ). Where possible , |
aides . A social worker may assist |
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early and repeat yearly if there are |
changes , feelings of hopelessness |
This may lead to an increased risk of |
include ongoing input from a dedi- |
with financial matters , access to |
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concerns about their suitability to |
and powerlessness and social exclu- |
social , behavioural and emotional |
cated young-onset dementia service |
NDIS and legal affairs , such as capac- |
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drive .
Funding
Funding for social and allied healthcare services for young people with dementia transferred from the aged care system to the NDIS in 2017 . This was welcomed by people with young-onset dementia and their fam-
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Managing psychiatric disorders , regardless of the presence of dementia , is crucial for maintaining quality of life .
sion . 41-43 The spouse often transitions into a caregiver ; this is challeng-
difficulties with the development of adverse mental health outcomes .
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or specialist . In the early stages , at least , repeat assessments , including neuroimaging and neuropsychology , are recommended to characterise the dementia symptoms and rate of progression . 17 This will inform prognosis . Repeat assessments are important for diagnostic stability ; some dementias , in particular |
ity , appointing power of attorney , accessing unemployment benefits and carer ’ s pension . 38
Non-pharmacological and pharmacological treatments
Cholinesterase inhibitors ( donepezil
, galantamine , rivastigmine ) and
|
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ilies , who felt that the goal-directed |
ing , as they assume a different role |
Children worry about the future , and |
bvFTD , are ‘ unstable ’, with individ- |
memantine ( an NMDA antagonist ) |
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and strengths-based approach of the NDIS suited their needs . 8 However , recent research demonstrates that people with young-onset dementia and their families have ongoing diffi- |
and more responsibility , in addition to loss of self-identity , changes in the spousal relationship and social
42 , 44 isolation . Spouses also face significant
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they require practical and psychological support at various times . 49
Most people with dementia prefer to live and die at home ; cognitive , functional and behaviour
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uals often diagnosed with a different condition , different dementia or
24 , 25
‘ undiagnosed ’. Patients with young-onset dementia can benefit from the ongo-
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are indicated in young-onset AD for treatment of the cognitive symptoms , but do not modify disease progression . 53 Managing psychiatric disorders , regardless of the presence |
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culty accessing the NDIS and finding suitable services . In particular , some patients with young-onset demen- |
financial stressors . Supporting spouses and families by checking in on their mental health , ensur- |
impairments can necessitate longterm care . 50 Traditional residential care facilities for older adults |
ing care of a collaborative multidisciplinary team . Regular medical ( psychiatry , geriatrics or neurology ) |
of dementia , is crucial for maintaining quality of life . Treat according to guidelines , such as with modified |
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tia report being denied access to the |
ing there is access to and support |
may be inappropriate for younger |
review of cognition , behaviours , pre- |
psychotherapy and antidepressants |
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NDIS because their impairments are not yet severe enough to meet the NDIS requirements . 8 |
available ( including counselling and psychological support ), as well as referral to the NDIS , can help . |
people and not provide the care required . 51 The Australian Government has pledged that no-one aged |
scribing and deprescribing of medications and general overview of the dementia is important , and the |
with short-term benzodiazepines for depression and anxiety . 53 Tables 3 and 4 list management for young-on- |
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GPs can assist with this process |
It is unclear whether caregivers |
under 65 will be entering and living |
addition of allied health profession- |
set dementia and potentially revers- |
|
by encouraging patients to make |
of people with young-onset versus |
in residential care by 2022 and 2025 , |
als can enhance management . Neu- |
ible forms of young-onset dementia , |
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an access request to the NDIS at |
older-onset dementia experience |
respectively . 52 |
ropsychology / detailed cognitive |
respectively . |
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the time of diagnosis and providing access request reports that reflect the person ’ s ‘ worst day ’ ( that is , their |
worse mental health , quality of life and caregiver burden ; 45-48 however , these care givers can spend more |
The NDIS offers two types of supported disability housing for its clients : Supported Independent |
assessments will determine stage and progression of dementia and can assist with cognitive strengths and |
The behaviour changes associated with dementia can be stressful for carers and individuals with |
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