This is arguably one of the greatest challenges in the elderly. I nearly daily get asked questions about behaviors associated with dementia. Often these patients can be aggressive, hit, spit, kick, swear, hallucinate, be sexually inappropriate, or have delusions. I was once asked what the best medication is to treat these behaviors. I relate that question to what is the best antibiotic to use. If there was one miracle medication that worked, every patient would be on it. It really depends upon what you are trying to treat, and often we can do an adequate job of treating these behaviors without medications or at least by thorough assessment of the patient in identifying the root cause of the behavior.
There are many questions to ask when assessing new or abnormal behavioral symptoms. Here’s just a few to focus on from the start:
1. Identify the specific behaviors and be sure to relay this information to the clinicians/caregivers who are helping in making decisions.
2. When did these behaviors start and what time(s) of the day do they happen?
3. Can we correlate the start of new behaviors to anything else? (i.e. fall, medication, stroke, family crisis, infection, change in environmental factors etc.)
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