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Review Article: Management of Behavioral Symptoms in Progressive Degenerative Dementias

¹ E. N. Rogers Memorial Veterans Hospital, Geriatric Research, Education and Clinical Center, Bedford, Massachusetts, and Departments of Pharmacology, Psychiatry, and Medicine, Boston University School of Medicine, Massachusetts.
² Center for Excellence in Nursing Practice, Brigham and Women's Hospital, and School of Nursing, Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts.

Management of behavioral symptoms of Alzheimer's disease and other progressive degenerative dementias poses continuous challenge to both family and professional caregivers. Behavioral symptoms are complex in nature and require that caregivers understand their presumed causes and intervene appropriately using validated caregiving techniques. Unfortunately, confusing terminology hampers improvement in management techniques. This review attempts to clarify terminology and specifically the behavioral symptoms "agitation" and "resistiveness to care" that require different management techniques. Several conceptual frameworks for behavioral symptoms of dementia are presented. These frameworks include behavioral models, a psychiatric model, and a comprehensive model that combines both behavioral and psychiatric strategies. Using precise terminology consistently and providing care based on a conceptual framework will facilitate the education of caregivers in appropriate techniques for management of behavioral symptoms of dementias.

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