As we age, chronic diseases that we had as younger adults follow us through the aging process. The mental and physical conditions that we had before continue to be part of our lives. The challenge is that as we age, we are not able to manage the diseases as effectively as we did when we were younger.
Dementia in isolation often has a behavioral element regardless of the cause of the dementia. We know that physical and verbal aggression may be symptoms of dementing conditions. Dementia may also manifest with symptoms of mental health conditions such as delusions and hallucinations. These delusions and hallucinations may lead the senior to harm themselves or others. Often, American society is not accepting of mental health conditions and individuals may have hidden these conditions their entire lives to protect themselves from society’s disfavor.
The challenge becomes more profound when these psychotic symptoms are manifesting, and caregivers do not have information about their life history. Someone with dementia is not able to provide an accurate history of their health and illness. Because of this, it is difficult for clinicians to evaluate the source of these symptoms and to order treatments because of limited data.
The senior with mental illness symptoms has the added risk of loss of executive function, poor safety awareness, and impulsiveness. When the delusions are paranoid in nature, the senior may not eat or take their medications because of fear of poisoning. This leads to self-neglect and physical illness on top of the mental illness symptoms.
The delusions and hallucination symptoms of mental health may mimic those of dementia. The medications for treatment of both conditions are similar, but there is the potential for worsened side effects in the senior with dementia. The medications are equally effective, but the individual must be monitored closely for adverse effects. If we do not know their life history of mental health, our treatment may be misguided due to this lack of critical information.
Because mental illness has such a stigma in society, it may be difficult to reach out for help because of perceived judgments. Remember that the brain is just as sick as the heart when there is a heart attack. We do not ignore chest pain, we seek treatment. Behavioral symptoms can be just a critical. Reach out for help as soon as you recognize issues. Help is available.