Dementia-Related Psychosis: The Caregiver’s Role
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Treatment for dementia-related psychosis is different for everyone. But one thingâs for sure: As a caregiver, you play a big role in your loved oneâs care plan. With your help, they can have a better quality of life for as long as possible.
Monitor Their Behavior
Your loved one might act in strange ways. Their behavior might be harmless.
For example, itâs common for people with dementia to think theyâre not in their own home. James Lai, MD, associate chief of clinical affairs for geriatrics at Yale School of Medicine, says people with dementia might even go to their room to gather some things. If all they want to do is pack a bag and unpack it, he says thatâs OK. You can even help.
âAs long as these [delusions] arenât stressful, you can participate in them,â Lai says. âIf you always tell them what theyâre doing isnât right, or you try to remind them that theyâre not going to this place, I think youâll see that creates more stress and anxiety.â
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It’s not always possible to calm your loved one on your own. They might get really upset or pushy.
âThis is where you want to involve your doctor,â Lai says.
But psychosis symptoms arenât always scary for the people who have them. Christopher van Dyck, MD, director of the Alzheimerâs Disease Research Unit at Yale School of Medicine, says those who have Lewy body dementia often see animals or people who arenât really there. But these beings tend to be non-threatening and even comforting.
âThe person having [the hallucination] can live very happily with extra dogs in the house,â he says.
Watch for Warning Signs
Itâs not always easy to tell if your loved one has a delusion or hallucination. They might not know it themselves. Lai says to watch for signs, like if they:
- Move things around
- Get upset or aggressive in certain situations
- Are afraid to go into a room
- Avoid certain people or places
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And sometimes, psychosis can be a sign of other medical problems, Lai says. It’s especially true if symptoms come out of the blue. Your loved one might not be able to tell you they donât feel well.
He says you should call the doctor if you notice:Â
- Sudden changes in behavior, mood, or personality
- Weight loss
- Lack of appetite
- Periods of staring
- Lots of falls
- Serious sadness or low mood
- Much more sleeping than usual
Work With Their Doctor
You can help your loved one get to their visits on time. And you can make sure they get their hearing, eyesight, or overall health checked. But thatâs not your only role. Arman Fesharaki-Zadeh, MD, a behavioral neurologist and neuropsychiatrist with Yale Medicine, says caregivers are a vital source of âobjective session-by-session updates.â
He suggests you should keep an eye on things like: Â
- What time do the symptoms happen?
- Do they show up around sundown?
- Do they happen around some kind of change?
- Does a new person cause them?
- Does your loved one get really anxious and scared in certain situations?
Jot down any information you have and bring it to their next appointment. Fesharaki-Zadeh says thatâll help you and your doctor look for patterns that might make your loved one’s dementia-related psychosis worse. You might be able to ease some symptoms if you can find and avoid certain triggers.
Carry Out the Treatment Plan
Your loved one might need medicine for their dementia or other health problems. Youâll need to make sure that they take it the right way.
If possible, Lai suggests you give them a part to play in their treatment routine. For example, put drugs in a machine that spits out the medicine when they press a button.
âGiving some kind of control back tends to be a good thing,â he says. âEven if itâs small.â
Carolyn Fredericks, MD, a neurologist who treats people with Alzheimerâs disease and other memory disorders at Yale Medicine, says medication probably wonât get rid of delusions. But it can help tone down symptoms that make psychosis worse, like agitation or confusion.
Some of these drugs come in patch form, she says, âwhich can be helpful if the person is suspicious and doesnât want to take pills.â
Get Support for Yourself
Itâs hard work to take care of someone with dementia. You might feel like youâre the only one who can or should do it. But that makes it more likely that youâll get caregiver burnout. Thatâs a state of physical tiredness or mental exhaustion. It could lead to medical issues for you that might include anxiety and depression. That can affect the quality of care you give your loved one.
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âEven the worldâs best caregiver needs rest and self-care,â Fredericks says. âThatâs how you get to be a good caregiver, by giving yourself a chance to be well.â
You can get extra help in lots of ways. Ask your doctor about:
- Home health aides
- Senior centers
- Adult day care
- Long-term living facilities
Fesharaki-Zadeh suggests caregivers reach out to groups like the Alzheimerâs Association. You can find access to a large network of dementia-related support.
âThese are people who are in the trenches dealing with these issues,â he says. âThey can be quite helpful and quite therapeutic.â
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