An individualised, non-pharmacological treatment strategy associated with an improvement in neuropsychiatric symptoms in a man with dementia living at home

BMJ Case Rep. 2019 May 9;12(5):e229048. doi: 10.1136/bcr-2018-229048.

Abstract

More than 90% of people with dementia experience neuropsychiatric symptoms which are often distressing and can result in early institutionalisation, diminished quality of life, increased frequency of emergency department visits along with stress and ill-health in caregivers. Non-pharmacological interventions are recommended as first-line treatment for neuropsychiatric symptoms, instead of medications such as atypical antipsychotics which have significant side effects. Most systematic reviews of non-pharmacological interventions for neuropsychiatric symptoms of dementia focus on patients in long-term care facilities and there are a limited number of research studies assessing the use of non-pharmacological interventions for patient's living at home. In this case report, we discuss an elderly man with dementia whose cognitive symptoms were accompanied by significant neuropsychiatric symptoms of suspicion, delusions, agitation and aggression. We describe how a programme of individualised, non-pharmacological interventions was associated with an improvement in neuropsychiatric symptoms within 3 months.

Keywords: Alzheimer’s Type; dementia; geriatric medicine; memory disorders; psychiatry of old age; vascular.

Publication types

  • Case Reports

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aggression / psychology
  • Behavior Therapy*
  • China
  • Delusions / psychology
  • Delusions / rehabilitation*
  • Dementia / physiopathology
  • Dementia / psychology
  • Dementia / rehabilitation*
  • Evidence-Based Medicine
  • Family / psychology*
  • Home Care Services*
  • Humans
  • Male
  • Patient-Centered Care* / methods
  • Physician-Patient Relations
  • Social Work, Psychiatric*
  • Treatment Outcome
  • Trust