Both pharmacological and nonpharmacologic interventions should be used to optimally treat and manage the cognitive, behavioral and psychological symptoms of Alzheimer's disease and other types of dementia.
Goals of care
Provide an environment with minimal failure and maximal use of retained abilities
Limit transitions: home to hospital to rehabilitation/skilled nursing facility to home
Develop treatment plan strategies
- Maximize function in daily activities
- Enhance cognition, mood and behavior
- Foster a safe environment
- Promote social engagement, as appropriate
- Justify every medication
- Eliminate redundancies and duplications
- Pharmacies can blister-pack medications for easy identification and compliance
- Reduction in drug passes may reduce errors and caregiver or care partner burden
Current medications cannot cure Alzheimer’s disease. There are two Food and Drug Administration (FDA)-approved treatments that address its underlying biology, however, Medicare coverage and access to these drugs are limited.
In addition, there are five FDA-approved Alzheimer's drugs that treat the symptoms of Alzheimer's disease for a limited time, with a goal of improving quality of life for patients and caregivers.
Your patients and their families may be using or have questions about alternative treatments, “prevention” food and vitamins, or “memory/brain booster” supplements.
There are legitimate concerns about using these products as an alternative or in addition to physician-prescribed therapy. Effectiveness and safety are unknown, purity is unknown, adverse reactions are not routinely monitored and dietary supplements can have serious interactions with prescribed medications.
Proven models for management
The Association strives to connect clinicians to effective evidence-based models of care that can be easily replicated. Explore the case studies that are paving the way for improved dementia care.
Behavioral and psychological symptoms of dementia (BPSD), for example, agitation, aggression, depression and psychosis, are associated with assisted living or nursing facility placement.1 Early recognition and treatment can reduce the costs of caring for these patients and improve the quality of life of the patient and caregiver.
Importance of the caregiver
Most patients living with Alzheimer's disease have a primary caregiver — often a family member — who is crucial to ensuring appropriate care for your patient with dementia. Doctors need to understand the role of the caregiver. Caregivers strive to meet all of the health and personal needs of the person living with dementia, but they often neglect their own. Many caregivers report high levels of stress, which can contribute to illness. Nearly 40 percent experience depression.
Physicians and other health care professionals can help by looking for signs of caregiver burnout, treating medical problems and referring them to support services, such as the Alzheimer's Association 24/7 Helpline (800.272.3900). We also offer caregiving information and guidance on how to maintain physical and mental health in the midst of caregiving, as well as advice on how to support a person living with dementia in their daily care, enhance their daily life, and respond to dementia-related behaviors.
Help and support for your patients
- 24/7 Helpline 800.272.3900: We can help your patients and their caregivers with questions and local support resources.
- Support groups: Patients living with Alzheimer's or another dementia and caregivers can find support and get advice at a local Alzheimer's Association support group.
- Alzheimer’s Association ALZConnectedⓇ: Our online community allows users to post questions about dementia-related issues, offer support, and create public and private groups around specific topics.
- Alzheimer's Association ALZNavigator™: This interactive online tool creates custom action plans for users based on their current situation and helps guide people living with memory loss and their caregivers to information, resources and next steps.
Monitoring Alzheimer's disease
After a diagnosis of Alzheimer's disease is made and a treatment plan implemented, patients should return for evaluation on a regular basis. Both cognitive and behavioral symptoms of dementia tend to change as the disease progresses, so regular visits allow adaptation of treatment strategies to current needs. Patients living with dementia may not be a reliable resource for history-taking, so encourage a family member, friend or caregiver to accompany the patient to all visits.
Educate and connect patients to the Alzheimer's Association. Our resources can be printed out or emailed directly to those affected by Alzheimer's disease or other dementias.
1. Toot S, Swinson T, et al. "Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis." International Psychogeriatrics. 2017; pp. 195 - 208.