Managing patients with dementia

1. Dementia is a clinical syndrome with several causes whichcreates impairments in mental ability, personality, affect andsocialisation.2. Information from family members can be very useful in theearly identification of cognitive impairment.3. Patients presenting with cognitive impairment should be evaluatedfor potentially reversible causes, with a range of laboratorytests and investigations.4. Sharing the diagnosis is one of the hardest parts of dementiacare. Family physicians/ general practitioners (FPs/GPs) shouldgive information gradually and sensitively.5. Dementia medications have only modest efficacy. It is encouragedto discuss the risks, side effects and benefits with thepatient and family.6. Non-pharmacological management such as regular structuredroutine, good sleep hygiene, reminiscence and cognitive stimulationcan help to improve the wellbeing of patients with dementia.7. During the course of dementia most patients develop behaviouraland psychological symptoms of dementia (BPSD).These result in a lower quality of life, high caregiver burdenand psychotropic drug use.8. When the burden of care exceeds the resources of the caregiver,nursing home placement commonly ensues.9. When patients with dementia lack mental capacity to make decisionsabout areas of their lives, legal processesmay be necessary.10. In dementia care there are considerable differences betweencountries and within countries