Document Detail


Issues facing home-based medical support services.
MedLine Citation:
PMID:  20738813     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The first part of the present review describes the current status of elderly people with behavioral and psychological symptoms of dementia (BPSD) in the community and basic viewpoints for differentiating between different forms of dementia. Specifically, it focuses on four points among the data and research related to determining the current status of elderly people with BPSD. We also propose basic concepts for differentiating between the core symptoms of dementia and BPSD, BPSD and delirium, and agitation and delirium. In the second part of the present review, various aspects of the symptom 'agitation' are discussed based on the experience of our home visit medical service for people with dementia by describing two cases. In cases such as Case 1, where the subject was given high doses of antipsychotics, we believe the problem was that the physicians immediately abstracted all of the abnormal behavior in the subject's life as 'agitation', and provided treatment to the subject accordingly. In Case 2, where the subject had dementia with Lewy bodies (DLB), we propose that it is crucial to differentiate clearly between agitation and delirium. Both of these cases show the risks of focusing treatment simply on agitation. When BPSD occurs in a person with dementia, the burden on caregivers increases. At such times, physicians tend to side with the family rather than with the patient. However, medical care is intended to be for the afflicted person, and physicians should base their plans for medical intervention on this principle.
Authors:
Toru Kinoshita; Hiroo Hanabusa
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society     Volume:  10     ISSN:  1479-8301     ISO Abbreviation:  Psychogeriatrics     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-08-26     Completed Date:  2010-12-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101230058     Medline TA:  Psychogeriatrics     Country:  England    
Other Details:
Languages:  eng     Pagination:  90-4     Citation Subset:  IM    
Affiliation:
Kodama Clinic, Shinagawa, Tokyo, Japan. toruk@yha.att.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Antipsychotic Agents / therapeutic use
Caregivers
Delirium / diagnosis,  drug therapy,  psychology*
Dementia / diagnosis,  drug therapy,  psychology*
Diagnosis, Differential
Home Care Services*
House Calls
Humans
Indans / therapeutic use
Lewy Body Disease
Male
Nootropic Agents / therapeutic use
Piperidines / therapeutic use
Psychomotor Agitation / diagnosis,  drug therapy,  psychology*
Tokyo
Chemical
Reg. No./Substance:
0/Antipsychotic Agents; 0/Indans; 0/Nootropic Agents; 0/Piperidines; 120011-70-3/donepezil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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