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Performance evidence
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Learning Outcome
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Date of activity and title: understand the administration of medication to individuals with dementia using a person centred approach (dem 305)
A.G.:
1.1
There are four different medicines available in the UK which can be prescribed for dementia. These are donepezil, rivastigmine, galantamine and memantine. They can come in different forms such as tablets, liquids, tablets that dissolve in water, or patches, and come in various brand /make names. Donepezil, rivastigmine, and galantamine belong to a group of medicines call acetylcholinesterase inhibitors. They work by increasing the level of acetylcholine. This is a chemical in the brain that is low in people with Alzheimer's disease. Memantine works in a different way to acetylcholinesterase inhibitors. It reduced the amount of a brain chemical called glutamate. It is thought that this may help to slow down the damage to brain cells affected by Alzheimer's disease.
Anti depressants are often given to as depression can be caused by dementia
While most changes in the brain that cause dementia are permanent and worsen over time, thinking and memory problems caused by the following conditions may improve when the condition is treated or addressed:
Depression
Medication side effects
Excess use of alcohol
Thyroid problems
Vitamin deficiencies
These can all be treated either by medication, diet or restricting access to certain things such as alcohol. The symptoms of dementia can be very distressing for both the person and there carers and family . things such as dilusion’s thinking family members are intruders /burglars etc can cause the person to be aggressive and upset as well a frightened .
A doctor specializing in dementia will decide which treatment is right for the patient. There are national guidelines for people with dementia caused by Alzheimer's disease that can help your specialist decide which treatment to choose.
One of the following is usually recommended: donepezil, galantamine and rivastigmine for people with mild or moderate Alzheimer's disease, providing that:
The medicine is started by a specialist in the care of people with dementia.
A person receiving treatment has regular reviews and assessments of their condition. (Reviews are usually carried out by a specialist team. Carers' views on the person's condition should also be sought before the medicine is started and should be considered during the reviews.)
Memantine can be considered as a treatment option for:
People who have moderate Alzheimer's disease and who, for some reason, cannot take, or are intolerant to, the acetylcholinesterase inhibitor medicines.
People who have severe Alzheimer's disease.
There are no national guidelines that guide treatment choice for people with other types of dementia. However, rivastigmine can be used for people with mild-to-moderately severe dementia who also have Parkinson's disease. So, doctors may suggest this medicine for this group of people. Also, an acetylcholinesterase inhibitor medicine may sometimes be suggested for people with dementia with lewy bodies who have problems with challenging or disruptive behaviour (non-cognitive symptoms).
It is thought that about half the people treated
