Coping with Obsessive-Compulsive Behavior and Dementia

Obsessive Compulsive Behavior in Dementia
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What Is Obsessive-Compulsive Disorder (OCD)?

OCD is a disorder characterized by obsessive thoughts and compulsive behaviors. It's not uncommon to see this challenging behavior in certain types of dementias such as frontotemporal dementia, Huntington's disease, and progressive supranuclear palsy. Late life development of obsessive-compulsive behaviors (as opposed to a life-long tendency) may be a sign that your loved one is in the early stages of dementia and should be evaluated by a knowledgeable physician.

With obsessive and/or compulsive behaviors, a loved one may have the need to repeat actions or behaviors multiple times. For example, your father might check the locks 12 times instead of once, repeatedly wash his hands until they're so dry that the skin cracks and bleeds, or constantly want to go to the bathroom.

How to Respond to Obsessions and Compulsions in Dementia

The key to responding to this type of behavior in dementia is determining whether the behaviors are simply a nuisance and harmless, or whether they present a danger to the person or those around him. If they're just harmless quirks, you're better off just accepting those characteristics and focusing your energy on other things.

Additionally, try to keep in mind that repetition in dementia, while perhaps related to some obsessions or compulsions, is often triggered simply by a poor short-term memory or anxiety in dementia. Adhering strictly to routines can be reassuring to people who are feeling disoriented or uncertain.

If the obsessions and compulsions interfere with safety or are causing the person distress, they should be addressed. Sometimes, verbal reassurances or distractions are helpful to people. Other people benefit from treatment with SSRIs, a class of antidepressants with fewer side effects that seem to be beneficial and provide some relief from OCD.

Sources:

Dementia and Geriatric Cognitive Disorders. Obsessive-compulsive behavior as a symptom of dementia in progressive supranuclear palsy. http://www.ncbi.nlm.nih.gov/pubmed/20798538

The Journal of Neuropsychiatry and Clinical Neurosciences, VOL. 12, No. 2. Late-Life Obsessive-Compulsive Disorder and Huntington's Disease. http://neuro.psychiatryonline.org/doi/full/10.1176/jnp.12.2.288

The Primary Care Companion for CNS Disorders.2011; 13(3). Late-Onset Cinephilia and Compulsive Behaviors: Harbingers of Frontotemporal Dementia. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184557/

University of California, San Francisco. Alleviating Symptoms: Compulsive Behavior. http://memory.ucsf.edu/ftd/livingwithftd/practicaltips/alleviating/multiple/complusions

University of California, San Fransisco. Medications for behavioral symptoms. http://memory.ucsf.edu/ftd/overview/ftd/treatment/multiple/behavioral

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