Non-Medical Treatments and Intervention

The development of therapies for dementia has been rapid and positive. Much attention has been paid to medications that can slow or prevent decline in cognition and function.

There is growing interest in the use of non-medical interventions, in other words, methods that do not involve medications. These methods often have a lower risk of side effects when compared to medications. Non-medical interventions may be more effective when used in combination with medications.

This section will discuss a variety of non-medical interventions for dementia that may be beneficial to patients with dementia and their caregivers.

Memory
Aids for memory are available for individuals coping with progressive decline in these abilities. Below are a few tools to help work with loss of memory and to stimulate the brain, improving cognition.

An electronic planner with an alarm function can remind patients to take their medicines. Additional non-medical methods to address memory problems can be found in the Memory Bible by Dr. Gary Small.

Research is being conducted at the Memory and Aging Center on specific and structured non-medical approaches to cognitive problems. The Merzenich Cognitive Re-Training Program is an on-going project that uses computer-based training to help build cognitive skills. This program was developed for patients with mild cognitive impairment or Alzheimer’s disease.

Language / Speech
Through directed exercises, individuals with aphasia and other speech symptoms can maximize their verbal communication or learn to use other methods of communication.

Careful assessment and treatment of language and speech symptoms may be performed by speech pathologists or occupational therapists. Many have their own practices, while others are available through local hospitals and medical centers.

Often, individuals are unable to articulate their needs because of language or speech problems. An example of an aid for non-verbal communication is a picture board which the person can use to indicate desired objects and concepts.

Behavior / Function
The treatments described below may be provided by rehabilitation specialists or by specially trained rehabilitation psychologists. These treatments may require the participation of caregivers for optimal effect. As an added benefit, therapies may reduce the stress involved with caring for an affected individual.

• Problem Solving Therapy is a structured program developed to address emotional and behavioral issues in older adults. This treatment takes a functional and skills building approach to distress by targeting concrete problems and then generating solutions. This program may be particularly helpful for caregivers.

• Procedural Memory Stimulation is a treatment that emphasizes the step-by-step behaviors involved in activities such as shopping, cleaning, and using the telephone. This type of therapy may be provided by rehabilitation therapists, who may be found in hospitals and community health centers.

For example, Restraint Free Care is a form of behavior therapy for older adults in residential treatment. It is a treatment that is amenable for modification in home-care settings.

Physiological Intervention
The importance of the following domains for optimum cognitive and emotional health cannot be over emphasized. must be included in any treatment strategy. These domains are also included for caregivers as extremely helpful management techniques to reduce caregiver stress.

Exercise – An exercise program that combines both strength training and aerobics is important for maintaining cognitive health. Cardiovascular exercise 2-4 days/week for approximately 30 minutes each time is very beneficial. A regular walk is one form of cardiovascular exercise and does not require membership to a gym. A common saying at the Memory Aging Center is, “What is good for the heart is good for the brain.” Individuals should consult with their physician before beginning any exercise program.

Sleep - Getting the proper amount of sleep has been shown to be critical for optimal cognitive performance.

Psychosocial/Emotional – for caregivers

• Educating one’s self about the disease will help families and caregivers to prepare the environment and to anticipate what may happen as the individual progresses in their illness. There are many websites and programs that may be available in your area. The Alzheimer’s Association is one of the best. For more information about programs in your area. Additionally, there are many links to helpful information on our website in the Caregivers and Resources sections.

  Care with Confidence
  Alzheimer's Association

  Diseases and Conditions: Dementia
  Aetna InteliHealth

• Group Therapy and Support Groups can provide information as well as emotional support for individuals diagnosed with a degenerative disorder as well as for family members. The UCSF MAC conducts two such groups for Frontotemporal Dementia (FTD) and Huntington’s Disease (HD). For more information, see the Events section.

• Many individuals diagnosed with a degenerative disease continue to live at home and rely on family and friends. To lesson the burden, assistance with home care is provided by many services such as Meals on Wheels, shopping, escort, and companions. Social workers can help locate or identify programs that will meet the needs of the individual and caregivers.

• The family environment has been shown to strongly influence the health of patients. Therefore, it is important to pay attention to the caregiver’s needs. The above treatments were introduced to provide additional avenues for caregivers as well as for patients. It is equally important for caregivers to maintain their emotional and physical well-being.

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