Marchello V, Boczko F, Shelkey M
Jewish Home and Hospital, Bronx Division.
Geriatrics. 1995 Mar;50(3):40-3; quiz 44-5.
The primary care physician plays a key role in the diagnosis and treatment of progressive dementia and in coordinating supportive care with the patient's caregivers. When a patient exhibits a new symptom such as wandering or verbal abuse, your initial workup should eliminate acute medical illness, psychiatric disorders, and drug reactions that may present as behavioral symptoms. In the home, the main focus of care is to provide a safe and secure environment, using preventive measures to minimize the risk of injuries. When caregivers become exhausted from dealing with nocturnal wakenings, a short course of sleep medication for the dementia patient is often necessary. To improve communication, avoid stressful and confusing situations that compound the patient's difficulty in understanding messages or expressing thoughts.
初级保健医生在进行性痴呆的诊断和治疗以及与患者护理人员协调支持性护理方面发挥着关键作用。当患者出现新症状，如徘徊或言语虐待时，你最初的检查应排除可能表现为行为症状的急性内科疾病、精神障碍和药物反应。在家庭中，护理的主要重点是提供一个安全可靠的环境，采取预防措施将受伤风险降至最低。当护理人员因应对夜间觉醒而疲惫不堪时，通常需要给痴呆患者短期使用睡眠药物。为了改善沟通，应避免造成压力和混乱的情况，这些情况会使患者在理解信息或表达想法方面的困难更加复杂。
