Microsoft word - web booklet word master dementia and treatments feb 2013.doc

Hampton House 1b Dyne Road London NW6 7XG Tel: 020 7604 5177 Fax: 020 7604 5178 www.brentmind.org.uk February 2013 Is the most common cause of dementia, accounting for about 60% of cases. During the Dementia is the name for a group of diseases that course of the disease the chemistry and structure affect the normal functioning of the brain. It is not of the brain changes, leading to the death of brain an inevitable part of the ageing process cells, which can’t be replaced. Alzheimer’s comes on gradually to begin with - the first noticeable Dementia is far more likely to affect older. About sign is usually short-term memory problems. 20% of people over the age of 80 develop dementia, but younger people can also develop the condition (less than 2% of people under 60). Is the second most common cause of dementia after Alzheimer’s disease, accounting for about 20% of cases of dementia. It is brought on by interruptions to the flow of oxygen to the brain Loss of memory: such as forgetting the way home from the shops, forgetting supplied through the network of blood vessels, resulting in the death of brain cells. This may occur suddenly fol owing a stroke or, more gradual y, as a result of a series of mini-strokes. Mood changes: because of damage to parts of the brain that control emotions, There is often a settled period, or even an improvement, after each episode of decline. You may experience acute confusion, depression and epileptic fits. Usually it has less effect on Communication problems: a decline in the ability to talk, read and write personality than Alzheimer’s. High blood pressure, heart problems, high The symptoms of dementia usual y get worse over cholesterol and diabetes can increase the chances time and can become quite disabling, so that it of developing vascular dementia so your doctor may be difficult for you to do some daily activities should check these and whether you are very overweight or whether you smoke or drink a lot of alcohol. You should be offered treatment and help Although dementia is a lifelong illness that usually Is caused by abnormal structures, known as Lewy gets worse over time, there are treatments that bodies, developing inside the brain. They lead to can slow its development or help with some of the an abnormal build up of protein inside nerve cel s, symptoms. There are two kinds of treatment which interrupt the brain’s functioning. Memory, concentration and language skil s are affected. It (Including Pick’s disease) account for about 5% of cases. The damage is usual y focused in the front part of the brain. At first, personality and Some of the treatments are recommended for behaviour are more affected than memory and specific types of dementia and some are for all language skills. Typically problems tend to appear kinds of dementia. If you have what is cal ed mixed dementia (for example, Alzheimer’s disease and vascular dementia, or Alzheimer’s disease and dementia with Lewy bodies), you should usually be treated for the type that is thought to be the main cause of your dementia. There are other, rarer causes of dementia including Korsakoff’s syndrome and Creutzfeldt- Jakob disease. People with Parkinson’s disease and Huntington’s disease are likely to develop If you have mild or moderate dementia, you dementia in the final stages. In the latter stages of should be offered the chance to join other people AIDS, a minority of people develop a form of with dementia in a cognitive stimulation The government’s National Institute for Health and professionals should take into account any Clinical Excel ence (NICE) recommends some disabilities or difficulties in communicating you drugs for the possible treatment of people with Alzheimer’s. They are donepezil (commercial y know as Aricept), galantamine (Reminyl), Only specialists should start prescribing these rivastigmine (Exelon) and memantine (Ebixa). They drugs, and you should only continue to take them treat the symptoms of Alzheimer’s disease, but while you, your doctors and your family or carers that do not slow the progression of the disease. agree they are having a worthwhile effect on your symptoms. You should have regular check-ups Donepezil, galantamine and rivastigmine prevent while taking any of these drugs, and if you have a the breakdown of a brain chemical cal ed carer, they should be asked about how you are acetylcholine, which is needed for the nerve cells chemical called glutamate. High levels of glutamate First, your care team should look at the situations damage nerve cel s in the brain and stop them that may affect your mood and the way you behave (for example, things that make you upset or agitated). They should look at things like your You should be able to have donepezil, galantamine physical and mental health, whether you are in or rivastigmine if you have mild to moderate any pain and side effects of medicines you are taking. Your treatment and care should be planned to suit your needs (including taking account of You should be able to have memantine if you your culture and beliefs), recorded in your notes, and reviewed regularly by your care team. moderate Alzheimer’s disease and cannot If you are agitated, you should be offered therapies to help calm you. These may include: When assessing the severity of your Alzheimer’s therapies that appeal to the senses, such disease and your need for treatment, healthcare carer. You may also be offered other help, such You should be offered help and treatment without drugs before you are offered medication, unless you are severely distressed or are at risk of If your non-cognitive symptoms are mild or If you have depression and the treatments above have not worked or are not suitable, you should antipsychotic because they can have serious side be offered antidepressant medicine. Your doctor should explain the risks and benefits of the treatment. He or she should also explain that it is If you have severe symptoms (such as psychosis important to take the drug as prescribed, that it or you are very agitated), you may be offered an will not start working straight away and that you antipsychotic for a period of time, but only after may have some withdrawal symptoms when you your doctor has talked to you in detail about the possible benefits and risks, which can include having a stroke or a heart attack. If you start taking an antipsychotic, it should be at a low dose at first, and your doctor should If it appears that the treatment described in this booklet is suitable for you, but it is not available, ask you doctor to explain why you cannot If you have depression or anxiety you may be offered a psychological treatment called cognitive behavioural therapy, which may involve your talk to your local Patient Advice and Liaison Service (PALS) London HA0 4UZ Tel: 020 8795 6240 www.brentcarers.org.uk Drug treatment for Alzheimer’s disease. A free factsheet from the Royal College of Psychiatrists. Provides information, advice and emotional Information about NICE clinical guideline 42 and support to carers of people with dementia Information about NICE technology appraisal guidance 217. Both are available from NICE (National Institute for Health and Clinical Excellence) and SCIE (Social Care Institute for You can be referred to the clinic by your GP can request a ful assessment of your needs. Contact your service office or Adult Care Services Tel: 020 8965 7711 www.ageukbrent.org.uk Support for African and Caribbean carers and c : provides access to health information The link below is to specific dementia information: Advocacy Service for mental health service users provides information and advice for carers. n : :provides information and advice on mental Mindinfoline: 0300 123 3393 (Monday to Friday Advocacy for elderly disabled people, mental health service users, and people with learning and a comprehensive range of leaflets on every aspect of dementia and has an online forum for U : provides information on and services for Dementia: support for family and friends. Dave Caring for the person with dementia: A handbook for families and other carers. Alzheimer’s Society C (National Institute for Health and Clinical Excellence): produces guidance for the NHS about Becoming a carer of someone with dementia. preventing, diagnosing and treating medical Stil going strong – a guide to living with dementia. C E (Social Care Institute for Excellence) Chocolate rain: 100 ideas for a creative approach to activities in dementia. Sarah Zoutewelle-Morris, Alzheimer's and Other Dementias: answers at your fingertips. Cayton, Graham, & Warner. Class Publishing (London) Ltd. 3rd edition, 2008 And stil the music plays – stories of people with Dancing with Dementia: My story of living The fol owing titles are al concerned with positively with dementia. Bryden. Jessica dementia, ranging from personal accounts to ‘how Kingsley Publishers (London & Philadelphia), to’ guides. They are listed in date order. You can also find useful books in your local library or from the Alzheimer’s Society’s library on their website.

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