Many of the delusions suffered by dementia patients may actually have a rational basis, meaning the disease could be more effectively treated through behavioral therapy rather than by psychotropic drugs, suggests the findings of a study published in Psychiatry Research in 2011, according to American Friends-Tel Aviv University.
The research was done in collaboration with Prof. Hava Golander of the Department of Nursing and Drs. Joshua Ben-Israel and Doron Garfinkel of the Shoham Medical Center, and examined six common categories of delusion found in 74 adults from nine nursing homes in Israel with dementia diagnoses.
“Dementia sufferers are often prescribed psychotropic drugs to mitigate symptoms such as delusions. But this tactic can cause more harm than good,” says Prof. Jiska Cohen-Mansfield of Tel Aviv University’ Herczeg Institute on Aging and Sackler Faculty of Medicine.
Researchers discovered that a large percentage of the delusions that the caregivers [in the study] described seemed to have logical explanations. Some were even the result of the patient re-experiencing traumas they had suffered earlier in their lives.
“If you begin to think about these delusions from the point of view of the dementia patient, you begin to understand that their delusions are explainable reflections of the reality they live in,” explains Prof. Cohen-Mansfield. For example, for patients who felt that they were not at “home,” the nursing home did not satisfy their definition of home. Anxiety often accompanied separation from the outside environment or from their loved ones—a rational response.
The study’s findings could have a significant impact on the way health care providers—including senior living operators—respond to dementia patients, according to Prof. Cohen-Mansfiled. Rather than characterizing dementia residents’ delusions as “psychotic,” which classifies them into a “severe mental illness” category, caretakers can look at ways to work with patients to take a patient’s background and context into account.
Read more at American Friends-Tel Aviv University.
Written by Alyssa Gerace