3.2 How to Treat Behavioral Symptoms of Dementia?

There is a six-step iterative approach designed to prevent, identify, and address behavioral symptoms of dementia. This framework offers primary care doctors a way to integrate nonpharmacologic approaches into their daily practice effectively.
Step 1: Identify whether or not a patient is suffering from behavioral symptoms. Screening is performed using standardized tools.
Step 2: Determine the symptoms that are occurring, recognize the danger of symptoms, and answer questions like the following:

• Are the symptoms sudden?
• Is there a safety concern?
• Is the caregiver distressed?

In this step, medications for the patient are reviewed, and the caregiver is educated.
Step 3: Find the underlying causes of the condition. Potential causes may be connected to the patient, the caregiver, or the environment.
Step 4: Create a treatment plan. A generalized approach may be used depending on the type of behavior/behaviors the patient shows. A treatment plan must have multiple strategies.
Three broad approaches can be used:

• Generalized Approach – It helps the person with dementia engage with their environment and improves the caregiver’s education, support, and skills.
• Targeted Approach – It uses problem-solving strategies to eliminate particular behaviors.
• Clinical Approach – The caregiver utilizes the help of a psychologist or a neuropsychiatrist.

Step 5: Evaluate if the plan has reduced the symptoms or if the symptoms have progressed. If the symptoms have worsened, the reason should be found, recommendations should be revised, and a new treatment plan must be formed with the help of experts.
Step 6: Perform monitoring, and reassess the symptoms, caregiver distress, and nonpharmacologic strategy use.