Managing families of the demented elderly

Dementing illness affects about 10 percent of people over 65 years of age, and families encounter many problems as they attempt to care for these relatives. Physicians can assist in several ways, beginning with establishing an accurate diagnosis, as terms such as "senility," "dementia," and "hardening of the arteries" are imprecise and may convey an attitude of hopelessness. A psychiatric, medical, and laboratory evaluation usually leads to a specific diagnosis. About one half of all cases are due to Alzheimer's disease, but there is frequently a treatable component to the demented patient's condition. In addition to making an accurate diagnosis and treating reversible problems, physicians can assist the family in having the patient do all he or she is capable of including increasing specific activities, can help the family understand that even their best efforts may not lead to improvement, can point out ways for the family to balance the patient's needs with their own, and can teach the family how to communicate more effectively with the patient.