U-M research outlines six-step approach to managing dementia symptoms without medication

In collaboration with Johns Hopkins University faculty, University of Michigan associate professor and researcher, Helen C. Kales, M.D., has identified six key strategies to help physicians evaluate and manage behavioral symptoms of Alzheimer’s disease and other dementias.

Nearly all patients with dementia develop visible and often distressing behavior changes as the disease develops. From repetitive questioning and agitation to hallucinations, disorientation and depression, the symptoms can have a significant impact on the patient’s daily functioning and quality of life. Despite the demand for comprehensive dementia care, physicians continue to face challenges finding low-risk, cost-effective therapies.

The strategies were outlined in “Nonpharmacologic Management of Behavioral Symptoms in Dementia,” which was published in The Journal of the American Medical Association (JAMA).

“Given the limitations and risks of current pharmacologic treatments, increasing the uptake of evidence-based non-pharmacologic treatments is imperative,” says Kales.

The authors’ six-step approach outlines strategies that can be used in virtually any clinical setting without drug treatment. Hence, they focus on how patients’ behaviors can be modified through changes in their environment. Working closely with caregivers is a key part of the process. Caregivers can play an important role in helping to characterize behaviors and identify ways in which a patient’s routine can be best adjusted to reduce symptoms. If a particularly difficult behavior is identified, physicians can also tailor the six-step approach to target and manage one symptom specifically. The six steps involve:

• Screening for symptoms early
• Describing the symptoms
• Identifying triggers and risk factors for the symptoms
• Choosing the proper interventions
• Evaluating the intervention to make sure it’s effective
• Following the patient’s progress over time

To help further connect these findings to practicing clinicians, JAMA has selected the authors to participate in its monthly Author in the Room Webinar on Dec. 19 from 2-3 p.m.

Anyone is welcome to join the discussion by enrolling at http://www.ihi.org/offerings/VirtualPrograms/Author/2012DecemberAIR/Pages/default.aspx.