A New Approach to Managing Dementia

Dementia, a chronic or persistent disorder of the mental processes and marked by memory disorders, personality changes, and impaired reasoning affects over 44 million people worldwide. Generally, these symptoms are treated with drugs, and the most common medications are antipsychotic.

To find another approach, a national multidisciplinary expert panel comprised of a dozen experts in dementia care collaborated to develop a four-step behavioral therapy approach referred to as DICE:

The four steps of the DICE strategy include the following:

• Describe. Caregivers should describe the symptoms and the contexts in which they occur to the dementia patient. Try to figure out cause and effect. Identify triggers to certain behaviors.

• Investigate. The caregiver or medical provider should attempt to identify, or exclude, possible underlying causes. These can include unmet needs – lack of sleep, a need for eyeglasses or hearing aids, toiletry needs, etc.  Evaluate all possible medical and environmental issues that could be provoking the symptoms of dementia.

• Create. Caregivers, providers and family should collaborate to create and implement a treatment plan. Treatments may be a combination of behavioral therapy and medication. Brainstorm behavioral and environmental approaches which could include a visiting nurse or occupational therapist. The five domains of generalized strategies suggested in this study are educating the caregiver; improving communication between the caregiver and patient; creating meaningful activities for the patient; simplifying tasks and establishing structured routines; and ensuring safety and enhancing the environment.

• Evaluate. Finally, evaluate the treatment plan periodically to determine whether it is working as intended or needs modifications.  

If you have a loved one experiencing signs of dementia, contact Stouffer Legal at 443-470-3599 in the Greater Baltimore area, to meet with experienced Elder Law and Estate Planning attorneys.