Dementia in Head Injury
Medical Treatment for Dementia After a Head Injury continued...
Behavior modification has been shown to be very helpful in rehabilitation of brain-injured persons. These techniques may be used to discourage impulsive, aggressive, or socially inappropriate behavior. They also help counteract the apathy and withdrawal common in head-injured persons.
- Behavior modification rewards desired behaviors and discourages undesirable behaviors by withdrawing rewards. The goals and rewards are, of course, tailored to each individual. The family usually becomes involved to help reinforce the desired behaviors.
- Persons who have insomnia or other sleep disturbances are taught "sleep hygiene." This instills daytime and bedtime habits that promote restful sleep. Sleeping pills are generally avoided in persons with head injury, who are more sensitive to the side effects of these drugs.
In general, cognitive rehabilitation is based on the results of neuropsychological testing. This testing clarifies problems and strengths in persons with dementia. The goals of cognitive rehabilitation are:
- Encouraging recovery in functions that can be improved
- Compensating for areas of permanent disability
- Teaching alternative means of achieving goals
For example, gradually increasing the time spent reading helps a person both improve concentration and develop confidence in his or her ability to concentrate. Keeping lists allows a person to compensate for decreased memory.
The use of medication to treat dementia symptoms in head-injured persons is discussed in the next section.
Family or network intervention
Head injuries often cause substantial family distress.
Changes of personality in head-injured persons, especially apathy, irritability, and aggression, can be burdensome to family members, especially the main caregivers. It is important that family members understand that undesirable behaviors are due to the injury and that the head-injured person is unable to control these behaviors.
Even when family members understand that the person is unable to control his or her behavior, the person's slowness, inappropriateness, and erratic responsiveness can be exasperating or even frightening. Family members become isolated from usual support, especially when the person's impairments are severe, prolonged, or permanent.
Mental health professionals recommend counseling for family members, especially those in caregiving roles. Ask your loved one's health care provider for a referral to a mental health provider and family support groups. These interventions improve morale and help family members cope.
Social services for head injury and dementia
A trained social worker can help the head-injured person with dementia apply for disability benefits, locate specialized rehabilitation programs, attend to medical problems, and participate in treatment.
Dementia symptoms such as poor reasoning, impulsiveness, and poor judgment may render the person unable to make medical decisions or to handle his or her own affairs. Social services can help in establishing a guardian, conservator, or other protective legal arrangement.
Medications for Dementia After a Head Injury
Persons with a head injury may require medication to treat symptoms such as depression, mania, psychosis, aggression, irritability, mood swings, insomnia, apathy, or impaired concentration. Headaches may also get better with drug treatment.