So far, there is no cure for frontotemporal dementia, or frontotemporal disorders (FTD) and no way to slow down or prevent these diseases.
However, there are ways to manage symptoms.
A team of specialists — doctors, nurses, and speech, physical, and occupational therapists — familiar with these disorders can help guide treatment.
Managing behavior changes in FTD
Behavior changes associated with bvFTD can upset and frustrate family members and other caregivers.
Understanding changes in personality and behavior and knowing how to respond can reduce frustration and help provide the best care for a person with FTD.
Managing behavioral symptoms can involve several approaches. Here are some strategies to consider:
Try to accept rather than challenge someone with behavioral symptoms. Arguing or reasoning will not help, because they cannot control their behaviors or see that they are unusual or upsetting to others. Instead, be as sensitive as possible and understand that it’s the illness “talking.”
Take a “timeout” when frustrated — take deep breaths, count to 10, or leave the room for a few minutes.
To deal with apathy, limit choices and offer specific choices. Open-ended questions, such as “What do you want to do today?” are more difficult to answer than specific ones, such as “Do you want to go to the park or for a walk?”.
Maintain a regular schedule, reduce distractions, and modify the environment to reduce confusion and improve the person’s sleep.
If compulsive eating is an issue, consider supervising eating, limiting food choices, locking cabinets and the refrigerator, and distracting the person with other activities.
To ensure the safety of a person and his or her family, caregivers may have to take on new responsibilities or arrange care that was not needed before.
Medications are available to treat certain behavioral symptoms. Antidepressants called selective serotonin reuptake inhibitors are commonly prescribed to treat social disinhibition and impulsive behavior.
People with aggression or delusions sometimes take low doses of antipsychotic medications.
If a particular medication is not working, a doctor may try another. Always consult a doctor before changing, adding, or stopping a drug or supplement.
Treating language problems in FTD
Treatment of PPA has two goals — maintaining language skills and using new tools and other ways to communicate. Treatment tailored to a person’s specific language problem and stage of PPA generally works best.
Since language ability declines over time, different strategies may be needed as the illness progresses. The following strategies may help:
Use a communication notebook (an album of photos labeled with names of people and objects), gestures, and drawings to communicate without talking.
Store lists of words or phrases in a computer or phone to point to.
Speak slowly and clearly, use simple sentences, wait for responses, and ask for clarification if needed.
Work with a speech-language pathologist familiar with PPA to determine the best tools and strategies to use.
Note that many speech-language pathologists are trained to treat aphasia caused by stroke, which requires different strategies from those used with PPA.
Managing movement problems in FTD
Medications and physical and occupational therapy may provide modest relief for the movement symptoms of FTD. A doctor who specializes in these disorders can guide treatment.
For people with corticobasal syndrome, Parkinson’s disease medicines may offer some temporary improvement.
Physical and occupational therapy may help the person move more easily. Speech therapy can help them manage language symptoms.
For people with progressive supranuclear palsy, sometimes Parkinson’s disease drugs provide temporary relief for slowness, stiffness, and balance problems.
Exercises can keep the joints limber, and weighted walking aids — such as a walker with sandbags over the lower front rung — can help maintain balance.
Speech, vision, and swallowing difficulties usually do not respond to any drug treatment. Antidepressants have shown modest success.
For people with abnormal eye movements, bifocals or special glasses called prisms are sometimes prescribed.
People with FTD-ALS typically decline quickly over two to three years. During this time, physical therapy can help treat muscle symptoms, and a walker or wheelchair may be useful.
Speech therapy may help a person speak more clearly at first. Later on, other ways of communicating, such as a speech synthesizer, can be used.
The ALS symptoms of the disorder ultimately make it impossible to stand, walk, eat, and breathe on one’s own.
Physicians, nurses, social workers, and physical, occupational, and speech therapists who are familiar with these conditions can ensure that people with movement disorders get appropriate medical treatment and that their caregivers can help them live as well as possible.
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