The Role of the Caregiver in the Drug Treatment of Dementia

Summary Although dementia is common among the institutionalised elderly, the majority of patients with dementia are cared for at home by nonprofessional caregivers, usually a spouse or adult child, As dementia progresses, the role of the caregiver expands from assistance with meal preparation, financial planning and medication administration to include personal care and decision making responsibilities. The chronic burden of these caregiver responsibilities affects the emotional and physical health of the caregiver and, as a result, can affect the patient. It is often caregivers who first seek a diagnosis and treatment for patients with dementia. Medication is becoming a more important part of the treatment of these patients. Tacrine is now available forthe treatment of Alzheimer’s disease in some countries, and other drugs are being investigated. Drugs have also been shown to be effective in modifying the risk factors for vascular dementia and in the treatment of behavioural problems associated with dementia. The administration of medication, monitoring of effectiveness and identification of adverse reactions are important aspects of caregiving and require interaction between the caregiver and the prescriber. The role of the caregiver in assessing the efficacy and adverse effects of medication and the impact of such medication on caregiver burden should be considered in the development of new treatments. There are instruments available to quantify the observations of caregivers, but few have demonstrated sensitivity or responsiveness to change in disease severity over time. Very little is known about the validity and reliability of caregiver observations. Further research needs to be done to develop and test instruments to capture information related to the function of patients with dementia and to caregiver quality of life. © 1995, Adis International Limited. All rights reserved.

Duke Scholars

Author Heidi Kay White Medicine, Geriatrics

Author Kenneth Edwin Schmader Medicine, Geriatrics