Therapy For Dementia

Therapeutic interventions for individuals with various types of dementia have come a long way in the past decade or so. While there’s currently no cure for this type of disease, there are various approaches to therapy that may be useful to an individual who is experiencing a dementia-related condition. 

Depending on their unique situation and the stage of dementia they’re currently in, some form of therapy may be used to help a person cope with related emotional challenges, improve symptoms, and increase cognitive function and overall quality of life. These are sometimes recommended in conjunction with medication and/or lifestyle adjustments. We’ll examine several of these treatment options here after giving a brief overview of some of the various types of dementia.

Types of dementia

Dementia is an umbrella term that refers to various levels of progressive cognitive decline that go beyond what’s considered to be a normal part of aging. For example, misplacing one’s car keys from time to time could be a normal part of aging, while getting lost or confused while driving to your neighborhood grocery store that you’ve been to many times could potentially indicate a dementia-related condition. 

Dementia symptoms can depend on the specific condition and may also vary from individual to individual, but a gradual decrease in cognitive abilities and memory over time is usually a core sign. There are several different types of dementia; just a few of these are outlined below.

Mild to moderate Alzheimer's disease

Alzheimer's disease is a progressive, degenerative disorder that affects the brain, and it’s the most common form of dementia among older adults. The cause of Alzheimer’s disease seems to be related to the formation of amyloid plaques in the brain, which impact the functioning of these cells. Mild to moderate Alzheimer’s in the early stages is usually characterized by symptoms such as:

• Forgetfulness and memory loss, like misplacing items or forgetting past or upcoming events
• Difficulty with communication and language
• Impaired judgment
• Confusion
• Changes in mood and behavior

As this form of dementia progresses, individuals gradually lose their ability to independently perform the activities of daily living, such as eating, bathing, and dressing. They will typically come to need assistance around the clock in order to remain safe and cared for once they’ve reached the stage of moderate to severe Alzheimer’s. 

There’s currently no treatment available for Alzheimer's disease. That said, doctors may recommend addressing its effects with medications—such as those designed to reduce amyloid plaques and those that may help decrease some symptoms—and one or more forms of counseling. Certain supplements and vitamins may also help slow the progression of cognitive decline, such as relatively high doses of vitamin E. The course of treatment may vary based on the healthcare provider's expert opinion and the condition's progression in a given individual. 

According to the Cleveland Clinic, vascular dementia is the second most common cause of dementia in older adults after Alzheimer’s. It can result from damage to brain tissue as a result of decreased blood flow, which can happen gradually over time or as the result of a blood clot caused by surgery or stroke. Some common symptoms throughout the stages of this dementia type may include mood and personality changes, behavior problems, confusion, stride changes and balance challenges, trouble concentrating, and trouble remembering upcoming events or past experiences, names, places, and details. 

Treatments for this type of dementia depend on the cause. Surgical interventions and medications to address the cause may be recommended in some cases, while medications and lifestyle adjustments may be used to help treat symptoms.

Parkinson's disease is a progressive neurological disorder that results from the death of nerve cells in the brain, gradually reducing an individual's ability to control their movements. The most common symptoms of Parkinson's disease include tremors and rigidity or stiffness in the limbs and trunk that can impair physical activity and mobility. In some cases, an individual with Parkinson’s may also develop dementia as a result of a buildup of amyloid plaques in the brain, which can result in changes in thinking, behavior, and movement.

Treatment for Parkinson's typically includes medications that may help improve movement symptoms. In addition to medication, physical therapy and occupational therapy may help an individual improve mobility, while speech therapy may help with communication challenges and general cognitive health. When symptoms overlap, healthcare providers like occupational therapists, physical therapists, and psychotherapists may all work together, depending on the patient’s unique needs.

Frontotemporal dementia, or FTD, is a degenerative neurological disorder that affects the frontal and temporal lobes of the brain. It’s a progressive neurological condition that significantly affects language, behavior, emotion, movement, problem-solving skills, decision-making skills, and personality. 

Key symptoms of FTD may include:

• Changes in social behavior
• Difficulty speaking or understanding language
• Loss of executive functioning 
• Inability to recognize familiar faces and objects
• Emotional instability
• Problems with balance and coordination

Treatment for FTD is similar to that of Alzheimer's. The main focus of a healthcare provider in this case is usually aiming to reduce emotional challenges and promote a good quality of life for individuals and their families as the disease progresses.

Mixed dementia refers to a condition in which symptoms of multiple forms of dementia occur simultaneously, such as those of vascular dementia, frontotemporal dementia, and/or others. This overlap can make it difficult for physical or mental health care providers to make a single diagnosis, so they may use the term “mixed dementia” instead. Mixed dementia is treated on a case-by-case basis and may require personally tailored treatment strategies based on the unique symptoms and needs of the individual. 

Treatment for dementia

While more research is needed to see if a cure may be possible for dementia someday, there are treatments currently available that could be helpful to those living with this type of disease.

When it comes to therapeutic dementia treatments, the goal is generally to slow the progression of the disease if possible while improving the individual's quality of life. This may be done by stimulating positive cognitive activity and "exercising" different aspects of the mind to cultivate healthier brain cells and improve mental health while reducing cognitive impairment. Counseling is often recommended in conjunction with certain lifestyle changes, such as advice to stay active through physical exercise, eat nutritious foods, and engage socially. Some types of counseling that may be suggested for a dementia patient include the following.

Problem-adaptation therapy is a form of progressive psychotherapy that uses adaptation techniques to help improve brain health and the ability to adapt to stressors. This form of counseling for dementia patients can be beneficial because it could increase their ability to cope with changing cognition levels, lifestyle factors, and emotions. 

A PATH practitioner will typically work to develop strategies to help the patient accept and adapt to changes and cognitive symptoms in a healthy manner. Research indicates that these psychosocial interventions may potentially help prevent emotional crises and improve life satisfaction, and they may even slow the progression of brain deterioration.

Cognitive behavioral therapy (CBT) is a common approach for dementia patients and one of the most common modalities in broader mental healthcare as well—which means it can also be used to support dementia caregivers. Both patients and caregivers may be at increased risk of experiencing symptoms of depression and anxiety, which CBT specifically can help treat. This modality focuses on helping the individual identify and shift patterns of negative thinking. So while this type of counseling for dementia won’t prevent the progression of the disease, it may help reduce symptoms of depression or anxiety that its symptoms can cause.

Reminiscence therapy is a type of cognitive behavioral therapy that involves helping an individual reconnect with their memories in an effort to create meaningful links between past experiences and current events. Through guided conversations about their childhood recollections and previous relationships, the patient may be able to develop a deeper understanding of themselves and cultivate a more positive outlook. 

Research from 2020 suggests that reminiscence therapy may help decrease symptoms of depression and improve engagement in and quality of daily life in dementia patients. In some cases, family members may be encouraged to partake in this type of therapy together with the patient for maximum benefit to both parties.

Cognitive stimulation therapy (CST) may be used to improve cognitive abilities and reduce the severity of dementia symptoms. It involves a series of structured activities that focus on problem-solving, memory recall, reasoning, and language skills. This intervention also encourages social interaction, potentially providing opportunities for meaningful communication between people with dementia and their caregivers and loved ones. 

During CST sessions, the individual will be guided through activities designed to stimulate the mind and help improve attention, concentration, logic, and judgment. These activities may include things like puzzles, board games, reminiscence work, art projects, music appreciation exercises, storytelling, or other approaches that a healthcare provider may deem appropriate for a given individual's unique needs. 

Studies suggest that CST may help improve cognitive functioning in people with mild to moderate dementia. This type of therapy for dementia may also help reduce agitation and other behavioral challenges commonly associated with this type of disease.

Art therapy may help individuals with dementia cope with the symptoms of their condition while also improving overall cognition and wellness. It can take the form of activities such as drawing, painting, sculpting, or creative writing depending on the patient’s interests and abilities. By engaging in these creative activities, a person with dementia may be able to regain a sense of control over their life and make use of a healthy outlet for emotional expression. 

Research indicates that the main potential benefit of art therapy for dementia is improved emotional control. Specific methods, such as Art, Colors, and Emotions treatment (ACE-t), may improve general cognition as well. This is because art therapy is thought to help create new neural pathways, which may allow individuals to find ways to adapt to their current reality and maintain their cognitive functioning. This may be combined with other forms of counseling based on the needs of the individual.

Medication-assisted treatment

Cholinesterase inhibitors are a type of medication that may be used to treat dementia—particularly Alzheimer's disease. They work by slowing the breakdown of a chemical messenger called acetylcholine. Acetylcholine is involved in key cognitive processes such as memory, learning, and concentration, and dementia is known to negatively impact levels of this important brain chemical. By counteracting the loss of acetylcholine, this type of medication may help reduce some symptoms associated with dementia.

Cholinesterase inhibitors may be paired with cognitive behavioral therapy for dementia or other forms of care to help maximize symptom relief. In fact, research suggests that combining these two treatments may improve the cognitive capabilities of an individual with dementia and increase their quality of life as well.

Alternative treatments

In addition to these more common types of counseling, some individuals may also choose to explore alternative treatments for dementia under the supervision of their doctor. Examples include massage therapy, pet therapy, supplements like ginkgo biloba, and lifestyle adjustments like staying active, avoiding social isolation, and finding ways to reduce stress and engage in healthy coping behaviors. Speak to your doctor before taking any dietary supplements or making any significant changes to your diet or activity levels.

Online counseling for dementia patients and caregivers

In some cases, individuals with dementia who are interested in seeking the support of a therapist will be advised to meet with a provider in person based on their current health and the status of the disease’s progression. In others, online therapy may be a viable alternative. It may be a more convenient and comfortable option for many, since it allows an individual to engage in therapy from the comfort of home. Online therapy may also be a valuable way for caregivers and loved ones of those with dementia to find emotional support in a way that fits into their busy schedules. 

With a platform like BetterHelp, you can get matched with a therapist who you can meet with virtually via phone, video call, and/or in-app messaging. In general, research indicates the potential effectiveness of online therapy, even when compared to traditional in-person methods. For example, consider a 2020 study that suggests that dementia caregivers experienced improvements in mood and mental health after engaging in an online therapy program.