brain, spinal cord, and nerve disorders
Dementia With Lewy Bodies and Parkinson Disease Dementia
Treatment
Safety and supportive measures Medications used to treat Alzheimer disease Treatment of dementia with Lewy bodies and Parkinson disease dementia involves general measures to provide safety and support, as for all dementias. Medications may be used to improve mental function and lessen symptoms. If behavior becomes disruptive and is not controlled by supportive measures, Medications that help control disruptive behavior are sometimes used. Creating a Beneficial Environment for People With Dementia can be very helpful. Generally, the environment should be bright, cheerful, safe, stable, and designed to help with orientation. Some stimulation, such as a radio or television, is helpful, but excessive stimulation should be avoided. Structure and routine help people stay oriented and give them a sense of security and stability. Any change in surroundings, routines, or caregivers should be explained to people clearly and simply. Following a daily routine for tasks such as bathing, eating, and sleeping helps people with Alzheimer disease remember. Following a regular routine at bedtime may help them sleep better. Activities scheduled on a regular basis can help people feel independent and needed by focusing their attention on pleasurable or useful tasks. Such activities should include physical and mental activities. Activities should be broken down in small parts or simplified as the dementia worsens. The same Medications , particularly Drugs Used to Treat Parkinson Disease may help relieve the symptoms of Parkinson disease (such as stiff muscles and tremor) in both dementias. However, in dementia with Lewy bodies, these medications may worsen confusion, hallucinations, and delusions. Pimavanserin, an antipsychotic medication, can be used to treat hallucinations and delusions in people with Parkinson disease. In dementia with Lewy bodies, Types of Antipsychotic Drugs tend to worsen muscle and movement symptoms and are best avoided. Newer antipsychotic medications, given in low doses, are preferred. However, newer antipsychotic medications, if used for a long time, may cause weight gain and abnormal fat (lipid) levels ( Caring for people with dementia is stressful and demanding, and caregivers may become depressed and exhausted, often neglecting their own mental and physical health. The following measures can help caregivers (see table Caring for Caregivers ): Learning about how to effectively meet the needs of people with dementia and what to expect from them:Caregivers can get this information from nurses, social workers, organizations, and published and online materials. Seeking help when it is needed:Caregivers can talk to social workers (including those in the local community hospital) about appropriate sources of help, such as day-care programs, visits by home nurses, part-time or full-time housekeeping assistance, and live-in assistance. Counseling and support groups can also help. Caring for self:Caregivers need to remember to take care of themselves. They should not given up their friends, hobbies, and activities. Before people with dementia with Lewy bodies or Parkinson disease dementia become too incapacitated, decisions should be made about medical care, and financial and legal arrangements should be made. These arrangements are called Advance Directives . People should appoint a person who is legally authorized to make treatment decisions on their behalf (a health care proxy). They should discuss their As the dementia worsens, treatment tends to be directed at maintaining the person’s comfort rather than at attempting to prolong life. 