10 non-drug ways to manage Lewy Body Dementia symptoms

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Lewy body dementia is a complex disease that includes physical, cognitive, and behavioural symptoms.

The behavioural symptoms can be the most upsetting and difficult-to-manage parts of the disease. Hallucinations, delusions, aggression, agitation, apathy, depression, and anxiety are common.

Because antipsychotic drugs are especially dangerous for people with Lewy body and could make difficult symptoms even worse, it’s best to first try non-drug treatments before resorting to medication.

Our friends at Daily Caring have shared 10 non-drug ways to help manage and reduce the severity of Lewy body dementia symptoms.

These suggestions should only be used if the situation is safe. If anyone is in danger of physical harm, immediately get medical help.

1. Tolerate behaviour that doesn’t cause harm, focus on reassurance and distraction

People with Lewy body dementia often experience hallucinations or delusions that cause strange behaviour or false accusations.

But if their behaviour isn’t aggressive or harmful, they don’t seem to have any physical pain or discomfort, and they’re not upset to an extreme degree, one solution is to tolerate the behaviour and not try to convince them of our reality to stop the behaviour.

Instead, respond to their emotions and concerns rather than the facts or exact words. Provide comfort as needed and assure them that they’re safe.

In these cases, the side effects of medication could be far worse than the hallucinations or delusions themselves.

2. Check for physical causes

Sometimes, new behavioural symptoms or a worsening of symptoms could be caused by physical pain or discomfort that the person isn’t able to verbally express or describe.

Common physical issues include severe arthritis, injury, fever, urinary tract infection (UTI), bed sores, and constipation. In some cases, simply being tired, needing to pee, or being hungry can also trigger negative behaviour.

When physical pain is well treated, negative behavioural symptoms often decrease.

3. Check for medication side effects

Sometimes medications used to treat Lewy Body dementia symptoms or other common health conditions can increase behavioral problems.

For example, over-the-counter sleep aids, bladder control medications, and drugs used to treat the physical symptoms of Lewy Body (tremors, shuffling walk, stiffness in arms or legs) can cause confusion, agitation, hallucinations, and delusions.

And benzodiazepines, common sedative medications to treat anxiety, can cause increased anxiety or worsen cognitive function in people with Lewy Body dementia.

If your older adult is taking any of these medications, speak with their doctor to find out if there are alternatives that are less likely to affect people with Lewy Body, if it can be eliminated, or if the dose can be lowered.

4. Modify their environment

Clutter, noise, and crowds can contribute to the hallucinations and delusions that typically trigger behavioural challenges.

Reducing clutter and minimising distracting noise, people, or activity can make it easier for someone with dementia to function, reduce their anxiety, and reduce the chance that their eyes will play tricks on them and cause them to become confused or upset about what they think they’re seeing.

5. Use kind, soothing responses to comfort and calm

Someone who has dementia is no longer able to process logic and reason the way we would. Keep them as calm and happy as possible by avoiding conflicts.

Assuming they’re not hurting themselves or others, this means going along with what they say, not correcting or arguing with them, and not quizzing them about what they remember.

If they’re agitated or concerned, validate their feelings and offer comfort through gentle hugs and engaging activities.

6. Create daily routines and keep tasks simple

Routine and simplicity both reduce the chances that they’ll get angry or agitated.

Having clear structure and consistent routine each day reduces uncertainty and confusion and creates a reassuring rhythm to life.

Break down everyday tasks into smaller steps to make them simpler and reduce frustration.

Overall, focusing on successes rather than pointing out failures (and making success possible) boosts self-esteem and positive feelings.

7. Encourage exercise and physical therapy

To help with the physical symptoms of Lewy body, physical therapy options include cardiovascular, strength, and flexibility exercises, as well as gait training.

Working on general physical fitness is also helpful.

Regular exercise also boosts mood, improves physical health, and often reduces aches and pains. All these factors contribute to reducing negative behaviour.

8. Consider speech therapy for swallowing problems

If Lewy Body is causing problems with swallowing, that will interfere with nutrition and cause hunger. Neither is good for someone’s mood or health – and it’s natural get “hangry” (hungry + angry) when we’re too hungry.

If that’s happening, consider speech therapy.

Speech therapists teach techniques that make swallowing easier and safer. They also make recommendations on the types and consistency of food and drinks that help with swallowing.

9. Consider alternative therapies

There are a variety of therapies that may help both the person with Lewy Body as well as caregivers.

Occupational therapy may help someone with dementia maintain skills and improve independence and confidence.

Music, or art can also reduce anxiety, improve mood, and give a sense of accomplishment.

Pet therapy, or using animals to improve moods and behaviours, boosts mood in many people. Caring for a pet, even if the pet is only visiting, can promote a sense of accomplishment and purpose.

Aromatherapy can boost mood and promote relaxation. Massage therapy can loosen stiff muscles, improve circulation, and promote relaxation.

Individual and family therapy or counselling can also be useful for learning strategies to manage emotional and behavioural symptoms. This can also help caregivers learn techniques to keep calm when conflicts come up.

10. Participate in caregiver support groups

Caregiver support groups have many benefits, including hearing from people in similar situations, being able to vent frustrations, and getting tried-and-true advice.

Getting support is essential for helping you stay as calm as possible in tough situations as well as for finding creative solutions to behavior challenges.

What to do if Lewy body dementia symptoms don’t improve

In some cases, non-drug methods aren’t enough to reduce or manage challenging symptoms caused by Lewy body dementia.

When someone’s behaviour is aggressive, dangerous, overly disruptive, or significantly impacts their quality of life, additional help is needed.

The best place to start is the doctor who is treating your older adult’s Lewy body dementia. They’re familiar with their health history, current medications, and any past reactions to medications.

If their doctor isn’t able to help and/or the behaviour symptoms are severe, a neurologist, geriatric psychiatrist (also called a geropsychiatrist), or geriatrician who specialises in tough dementia cases may be more helpful.

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