Balanced Review of Anti-psychotics for Dementia Challenging Behavior

Medication Induced Cognitive Impairment

These are easy to fix, should be evaluated, and not missed. Registration required, but free.

Alzheimer's vs. Vascular Dementias

Free CME and review.

Guidelines for Dementia Care

Registration free but required to above site.

See also.

Here.


AHRQ Report.

Guide to Surveyors of Long Term Care Facilities. Only 500 pages.

Rember

Twice as good as current medications. The British NHS has banned Aricept.

Bereavement

Mood Disorders

The Geriatric Doper

Anxiety Disorders in the Elderly

Agitation Review

Dementia Sensitive Culture

Here. Most aggression takes place during care. Document triggers from prior shifts. Videotape to see what mistakes are being made. Listening helps the anxious patient. So, one staff talks to the patient as another does the care. Do not kneel to put shoes on, the patient may pull the hair and kick. Tone of voice should convey choice giving and not orders.

Ethics and Law in Long Term Care

Here. Much bossiness and contradicting of clinical judgment and equally valid cultural differences.

And here. It is not settled that hospices do a better job than hospices, at the end of life, even in a specialty such as pain control.

Advantages of Flexibility with Staff

Here.

Case of Hypersexuality in Dementia Relieved by Sertraline

Patient continually demanded sex from wife, and got violent if refused. On sertraline 50 mg b.i.d., both excessive sexuality and aggressiveness diminished. ALS 8:189-190, 2007.

Antipsychotics Increased Mortality in a Large Canadian Study

Here. The effect is weak. It likely would not be felt at the clinical level. This large sample included typical neuroleptics. These cause more movement side effects, have greater effects on cardiac function and on blood pressure. The sample did not include any use of aripiprazole nor ziprasidone.

Compared to the risk of agitation, self-injury, and injury to others, this increased risk is small.

Suicidal Ideas Among Seniors with Home Health Care

Here. About 10% thought of suicide; 7% had made an attempt; 1% in the past year.

Guidelines for Palliative Care

Reviewed here. Regularly assess pain, dyspnea, and depression. Use proven therapies for each. All patients should have had advanced care directives.

Aging Dopers

Here.

Geriatric Psychiatry Under-Utilized in Nursing Homes

Here.

Tics

Here.

Food Store Hazards

Here.

Light Therapy for Sleep Problems and Depression

Here.

Who Needs One More on Earth?

Here. Good idea.

Low Free Testosterone Associated with Depression in Older Males

Here. This makes sense. Females have lower testosterone and more depression.

Cholinesterase Inhibitors in Schizophrenia - Not Really

Here.

Late Life Anxiety

Here.

Review of Multi-Disciplinary Approach to Alzheimer's Disease

Here.

Thoughts and Behavior in Frontro-Temporal Dementia

Reviewed here. And, a general review here.

Cooling to Slow Neurodegeneration

Here.

End of Life Guidelines

What evidence exists, is about cancer. Assess and address pain, shortness of breath, and depression. Here. It has only 650 pages.

Dementia in Minority Populations

Reviewed here. Here. Most factors are modifiable.

Biological Markers of Alzheimer Dementia

Here.

Psychosocial Approaches to Alzheimer Dementia Patients

Reviewed here.

This brings up the idea of therapy with AD patients. The idea that talking to someone who will not remember the conversation a minute after leaving has no rationality.

Guidelines for Dementia Medications

Here.

Preventing Falls

Here.

Use of Anti-Psychotics in Elderly Demented Patients

Reviewed here. The causes of death were varied and non-specific. The sample size was large. The rate of death was low. The wrong statistical test was applied. Although the risk of death is higher on typical anti-psychotics than on atypicals, the atypicals carry no black box warning. This is the wacko world of the moronic FDA. That agency should be disbanded.

Drug Interactions with Cholinesterase Inhibitors

Reviewed here.

Challenging Caregivers

Reviewed here.

Clozapine for Agitation in Dementia

Retrospective study reviewed here.