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Dealing with Dementia Behaviors

Dealing with Dementia Behaviors. Charles Crecelius MD PhD FACP CMD. Apathy (50%–70%) Agitation (40%–60%) Mood lability (40%) Blunted affect (40%) Disinhibition (30%–40%) Withdrawal (30%–40%) Delusions (20%–40%). Anxiety (30%–50%) Suspiciousness (30%) Dysphoria (20%–40%)

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Dealing with Dementia Behaviors

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  1. Dealing with Dementia Behaviors Charles Crecelius MD PhD FACP CMD

  2. Apathy (50%–70%) Agitation (40%–60%) Mood lability (40%) Blunted affect (40%) Disinhibition (30%–40%) Withdrawal (30%–40%) Delusions (20%–40%) Anxiety (30%–50%) Suspiciousness (30%) Dysphoria (20%–40%) Hostility (30%) Aggression (10%–20%) Hallucinations (5%–15%) Selected Behavioral Symptoms in Dementia Sultzer DL. Postgraduate medicine: A special report. 1999:19-26.

  3. Etiology of Dementia BehaviorsIntrinsic Factors • Brain damage • Co-morbid diseases • Medications • Pain • Physical needs

  4. Etiology of Dementia BehaviorsExtrinsic Factors • Environment • Social • Staff

  5. Behaviors Warranting Urgent & Probable Medication Interventions • Violent behaviors (not redirectable) • Distressing hallucination, delusions or paranoia • Abrupt worsening (pending evaluation) • Depression with rapid change / functional impairment

  6. Nonpharmacologic Approach to Behaviors • Define the behavior • Determine the nature and extent as a problem • Determine why the behavior occurs • Design interventions • Evaluate and redesign as needed

  7. Basic Principles of ProblemBehavior Solving Strategies • Early intervention • Confrontation aviodance • Control excess stimulation • Distract and redirect • Maintain dignity

  8. Therapeutic Music Sensory Reminescent Social Control Mechanisms Contextual Consequential Stimulus Behavior Interventions

  9. End of Life ChangesAffecting Behavior • Worsening “4 A’s” • Concomitant diseases • Difficulty defining behaviors • Care plan goal changes • Shifts in behavior types • Intervention limitations

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