Guidelines for the Management of Cognitive and Behavioral Problems in Dementia

Reduce choices

Provide the patient with a predictable routine (eg, exercise, meals, and bedtime should be routine and punctual)

Avoid relocation; if necessary bring familiar items

Allow the patient to dress in his or her own clothing and keep possessions

Use calendars, clocks, labels, and newspapers for orientation to time

Use color-coded or graphic labels (eg, on closets, table service, drawers) as cues for orientation in the home environment

Do not be overly concerned if they are not distressing to the patient

Consider antipsychotic agents where necessary, but fully inform family and caregivers of the risks/benefits of these medications

Redirect and distract the patient

Consider using antipsychotic medications

Answer decisively, then distract

Ensure tasks are simple so that the patient can complete them; break up complex tasks into smaller steps

Before performing all procedures and activities, explain them to the patient in simple language

Register the patient in the Alzheimer's Association Safe Return Program

Secure the environment with complex handles

Equip doors and gates with safety locks

Inform neighbors

Use distraction and redirection of activities to divert the patient from problematic situations

Reduce excess stimulation and outings to crowded places (overexposure to environmental stimuli can lead to agitation and disorientation)

Use lighting to reduce confusion and restlessness at night

Avoid glare from windows and mirrors, noise from a television, and household clutter

Provide a safe environment (eg, no sharp-edged furniture, no slippery floors or throw rugs, no obtrusive electrical cords)

Install grab bars by the toilet and in the shower