• Anti-psychotics, given at night
• Serotonin-affecting drugs (trazodone, buspirone)
• Dopamine blockers (haloperidol, Risperidal, olanzapine, clozapine)
• Cholinesterase inhibitors [donepezil (aricept), rivastigmine (exelon), or the newly approved galantamine (reminyl) for Alzheimer's-type dementia]
• Fluoxetine, imipramine, or Celexa to help stabilize mood
• Stimulant drugs (such as methylphenidate) to increase activity and spontaneity
• Vitamin E

Sensory function should be evaluated regularly and hearing aids, glasses, or cataract surgery should be provided as needed.

Formal psychiatric treatment such as psychotherapy or group therapy is seldom helpful because it may overload the limited cognitive resources in the person with dementia.

LONG-TERM TREATMENT:

Providing a safe environment, controlling aggressive or agitated behavior, and meeting the physiologic needs of a person with dementia may require monitoring and assistance in the home or in an institutionalized setting. Possible options include in-home care, boarding homes, adult day care, and convalescent homes.

Visiting nurses or aides, volunteer services, homemakers, adult protective services, and other community resources may help in caring for the person with dementia. In some communities, support groups may be available (see elder care - support group), and family counseling can help family members cope with home care.

In any care setting, there should be familiar objects and people. Lights can be left on at night to reduce disorientation. The activity schedule should be simple. Behavior modification may help some people to control unacceptable or dangerous behavior. This consists of rewarding appropriate behaviors and ignoring inappropriate ones (within the bounds of safety). Reality orientation, with repeated reinforcement of environmental and other cues, may also help reduce disorientation.

Legal advice may be appropriate early in the course of the disorder, before the person with dementia becomes too incapacitated to make decisions. Advance directives, power of attorney, and other legal actions may make it easier to decide about the care of the person with dementia.

• Loss of ability to function or care for self
• Loss of ability to interact
• Increased infections anywhere in the body
• Reduced life span
• Abuse by an overstressed caregiver
• Side effects of medications used to treat the disorder

• Call your health care provider if dementia develops or a sudden change in mental status occurs.
• Call your health care provider if the condition of a person with dementia deteriorates and you are unable to cope with caring for that person in the home.