The Curbsiders Internal Medicine Podcast #82 Dementia Dos and Don’ts: The GeriSiders
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Feb 12, 2018 In this insightful discussion, Dr. Eric Widera, a geriatrics expert, and Dr. Leah Witt, a Geriatrics Fellow, challenge common dementia treatment practices. They delve into the controversial use of cholinesterase inhibitors and antipsychotics, revealing risks and emphasizing patient-centered care. The duo advocates for the DICE approach to manage difficult behaviors and highlights the ethical implications of feeding decisions in advanced dementia. Their engaging dialogue underscores the importance of individualized care and effective communication with caregivers.
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Understanding Patient Perception
- When discussing a dementia diagnosis, first understand the patient's perception of their condition.
- Use the SPIKES framework to deliver bad news effectively and address emotions.
Engaging the Patient
- Include the patient in the conversation, even with the caregiver present.
- Spend time acknowledging and addressing the emotional reactions to the diagnosis.
Cholinesterase Inhibitors: Cautious Use
- Prescribe cholinesterase inhibitors cautiously, assessing benefits and side effects.
- These medications offer minimal impact and may cause weight loss, nausea, and GI distress.
