Major or Mild Frontotemporal Neurocognitive Disorder

Treatments

Psychological and Pharmacological (Neuroleptics)     

Treatment Summary: Neuropsychiatric symptoms fall into three main syndromes: agitation, psychosis, and mood disorders. These three syndromes produce symptoms ranging from aggression and irritability, to psychotic delusions and hallucinations, to full blown depression. The first priority is to build an environment for the patient’s physical and psychological safety. Once patients’ safety is established then pharmacological drugs, such as neuroleptics, are used to treat various types of dementia disorders. Alzheimer’s disease is the primary foundation upon which dementia research is founded. Risperidone seems to be the best effect drug so far, although results for improvement are modest. Prognosis for recovery is limited at best. 

• Reference: Ballard, C., Day, S., Sharp, S., Wing, G., & Sorenson, S. (2008). Neuropsychiatric symptoms in dementia: Importance and treatment considerations. International Review of Psychiatry, Vol. 20(4), 396-404. 

• Submitter: Tim Reynolds 

Music Therapy Based Psychological Intervention 

Summary of Treatment: A multi-component psychological intervention designed to alleviate neuropsychiatric symptoms and to improve communication in mild to moderate dementia was evaluated in a controlled trial. Components were 1) cognitive-behavioral and environmental interventions adapted for dementia and 2) music therapy. Results: relative to controls, the treatment group showed partly significant reductions of agitation, aggression, apathy, anxiety, and improvement of communication, emotional expression, and activity. It was proven that the intervention can help to increase psychological well being in patients with dementia. 

• Reference: Fischer-Terworth,C.,& Probst,P. (2011). Evaluation of a TEACCH-and Music Therapy- Based Psychological Intervention in Mild to Moderate Dementia. Gerontology/Psychology, 24 (2), 93-101. 

• Submitted by: Dana Gordon 

Cognitive-stimulation Therapy and Recreational Activities 

Treatment Summary: Cognitive interventions are suggested for dementia as well as delirium superimposed on dementia, such as cognitive-stimulation therapy for Alzheimer’s disease. This involves guided practice in various areas of cognition. Some of these areas of cognition include participation in recreational activities. Some of these activities include participating in board games with other elderly patients, playing musical instruments, and dancing. In a case study, a woman was prescribed a game of hangman, coming up with words that fit into the category of ‘type of card game’, such as poker, solitaire, bridge, and pinochle, searching a picture for different baking instruments, such as a mixer, spatula, spoon, and measuring cup, and four-corners bingo. Her activities were limited to 30 minutes daily to prevent fatigue. Results: The benefits from these activities include their building cognitive-reserve capacity, maintaining functioning, and reducing excess disability. Other studies showed that recall of remote memories occurred. These activities will also help to capture that person’s attention and engage them for longer periods of time than activities that are not suited to their particular interests. Individuals who participate in these activities are shown to experience less cognitive decline and a quicker return to normal activities than they would show without these activities. This therapy also offers multi-domain cognitive activities that are shown to produce larger and more significant results than single-domain cognitive activities. These activities are also less stressful to these elderly adults. 

• Reference: Kolanowski, A. M., Fick, D. M., Clare, L., Therrien, B., & Gill, D. J. (2010). An intervention for delirium superimposed on dementia based on cognitive reserve theory. Aging & Mental Health, 14(2), 232-242. doi:10.1080/13607860903167853 

• Submitter: Michael Gunter 

Meaningful Tasks & Providing Pleasure 

Summary of Treatment: Treatments for cognitive disorders should primarily focus on doing meaningful tasks to act at the start of this disorder in order to slow the declining process, as there is no concrete cure. The primary treatments for pedophilia included meaningful tasks, providing pleasure, or a combination of the two. Specifically, a type of nonpharmacological therapy was implemented such as baby doll therapy in order to get the patients mind focused on a specific task (Braden & Gasper, 2015). Baby doll therapy serves the purpose of decreasing frustration from losing the ability to do things you were once capable of doing, in fact the responsibility in holding the baby doll leads to some patients even seeing it as a real baby (Braden & Gasper, 2015). Overall, this therapy demonstrates the impact of giving these patients a care giving task. These psychosocial activities, when implemented, can treat some emotional symptoms as well as possibly slowing the progression of neurocognitive disorders. Providing pleasure through person-centered therapy has also been seen to focus on this improvement of quality of life (McNiel & Westphal, 2018). The use of a Namaste technique is implemented to make it less of a task and more of an enjoyable activity that gets the individual more engaged. This specific technique implements routine care but in a more positive way. Rather than it being something the patient has to work at, they are able to feel more relaxed while gaining the same care in the process (McNiel & Westphal, 2018). The setting is typically one free of distractions and creating a peaceful place for the patients (McNiel & Westphal, 2018). The purpose of this is to take the patients mindset away from the reality of being incapable of doing activities. They are being pampered and even feel empowered in being themselves. The care is also personalized to the individual in order to allow the patients to remain connected to how they once were and again just encouraging normalcy in their lives (McNiel & Westphal, 2018). The idea is to promote engagement in activities these patients enjoy so that they keep wanting to do them.  

• Reference: Braden, B. A., Gaspar, P. M. (2015). Implementation of a baby doll therapy protocol for people with dementia: Innovative practice. Dementia: The International Journal of Social Research and Practice. 14(5), 696-706. https://doi-org.tamuct.idm.oclc.org/10.1177/1471301214561532 McNiel, P., & Westphal, J. (2018). Namaste care: A person-centered care approach for Alzheimer’s and advanced dementia. Western Journal of Nursing Research, 40(1), 37-51.  

• Submitted by: Catherine Atkinson 

Occupational Therapy  

Summary of Treatment: Treatment from occupational therapists (OT) for patients with cognitive dysfunction from a traumatic brain injury (TBI) is one of the many types of rehabilitation methods used for this disorder. The OT’s objective is to bring meaningful improvements to the client’s life by teaching them to use assistive devices. They also focus on having the mind and body work together again. The overall goal is to strengthen the cognitive state by utilizing a strengths-based approach and several different models based on the need. Occupational therapy focuses on more than what is on the surface and truly highlights the executive functioning and life achievement needs.   

• Reference: Stephens, J. A., Williamson, K.-N. C., & Berryhill, M. E. (2015). Cognitive Rehabilitation After Traumatic Brain Injury. OTJR: Occupation, Participation and Health, 35(1), 5–22. https://doi.org/10.1177/1539449214561765 

• Submitted by: Makayla Philson