dementia — a method known as DICE — based on several decades of scientific research as well as extensive clinical practice .
REBECCA BLACKWELL / ASSOCIATED PRESS Aggression can often accompany dementia , making care difficult , but experts are finding ways to better handle these situations .
New help in dealing with
AGGRESSION in people with dementia
STORY BY JUDITH GRAHAM KFF Health News
Caring for older adults with dementia is stressful , especially when they become physically or verbally aggressive , wander away from home , develop paranoia or hallucinations , engage in inappropriate and repetitive behaviors or refuse to let caregivers help them .
Upward of 95 % of patients experience these neuropsychiatric symptoms of dementia , which tend to fluctuate over time and vary in intensity . They ’ re the primary reasons people with dementia end up in assisted living facilities or nursing homes . At some point , families and friends trying to help at home simply can ’ t manage .
“ When people think about dementia , they usually think about forgetfulness and memory impairment ,” said Mary Blazek , director of the geriatric psychiatry clinic at the University of Michigan . “ But it ’ s behavioral and psychological disturbances that are most disruptive to patients ’ and caregivers ’ lives .”
Now , help is available from a first-of-its-kind website . It offers free training in a comprehensive approach to managing neuropsychiatric symptoms of
The website ’ s goal is to “ give people tools to better manage often-distressing situations ,” said Helen Kales , chair of the Department of Psychiatry and Behavioral Sciences at UC Davis Health in Sacramento , California , and one of DICE ’ s creators . Users learn that neuropsychiatric symptoms are caused by changes in the brain that increase people ’ s vulnerability . Nine video modules and two simulations provide comprehensive information and problem-solving techniques .
More than 16 million unpaid caregivers — primarily family members and friends — help people with dementia live at home ( an estimated 20 % of patients live in institutional settings ). The most common form of dementia , Alzheimer ’ s disease , affects nearly 7 million Americans 65 and older .
DICE is also designed to help “ avoid the knee-jerk prescribing of psychoactive medications ” that have potentially serious side effects , Kales said . Several medical organizations recommend that non-pharmaceutical approaches to troublesome behaviors be tried before drug therapy , but , in practice , this doesn ’ t routinely happen .
Drugs prescribed for dementia include antipsychotic medications , such as Risperidone , which carry a black-box warning noting an increased risk of sooner-than-expected death in elderly patients ; anticonvulsants , such as gabapentin , for which use has been on the rise despite concerns about safety ;
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