Currently there is no treatment for dementia which can reverse or stop the symptoms of the disease. There are, however, a number of approaches which can slow its progression and assist people with dementia and their families to cope with many of the challenges associated with dementia and the stresses of caregiving. These approaches are outlined below.
Psychological approaches
Cognitive behavioural therapy (CBT) and supportive psychotherapy can help those with early stages of dementia understand and adjust to their diagnosis, and find effective ways of coping. CBT can also be used to address symptoms of depression and anxiety which are often experienced by those with dementia. Cognitive and memory training in the early stages of dementia has also been shown to have some benefits at slowing the neurocognitive declines associated with dementia.
Behavioural approaches
A number of behaviours associated with later stages of dementia that can cause concern include wandering, agitation, aggression, and repetitive questioning. Behavioural interventions can be used to help ease such behaviours, and typically involve:
- identifying a problem behaviour
- gathering information on its possible triggers and working to minimise these
- modifying the behaviour through reinforcement and by redirecting the person to familiar and enjoyable activities
- evaluating the success of the intervention and adjusting strategies as needed.
Encouraging a healthy lifestyle which includes moderate physical activity, a balanced diet, and medication adherence can also be of benefit as it can help improve cognitive functioning and reduce risk factors such as high blood pressure and cholesterol.
Environmental approaches
- Keeping a person’s environment constant and familiar will them make better sense of their surrounds, and maintain their independence.
- Minimising complexity in the person’s environment can also decrease confusion and distress and help maintain independence. Useful strategies include simplifying the layout of rooms, removing clutter, decreasing noise, and adding simple signage and cues around the home.
Approaches for carers
Caring for someone with dementia can be stressful. There are a number of practical approaches which can help caregivers reduce their stress and maintain their own wellbeing, including:
- empowering the carer to seek practical support, such as arrangements for day respite
- empowering the carer to seek professional advice when making arrangements for their loved one, such as making a will, arranging powers of attorney, or the termination of a driving licence
- supporting the emotional needs of the carer, and providing assistance around adjusting to changes and declines in the health of the loved-one, and providing effective treatment for depression or anxiety if this is required
- connecting with caregiver support groups, which can also help improve psychological well-being, decrease depression and feelings of burden, and improve the social networks of caregivers.