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P3‐352: An approach to dealing with negative behaviors in patients with frontotemporal dementia
Author(s) -
Drubach Daniel
Publication year - 2011
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2011.05.1794
Subject(s) - frontotemporal dementia , psychology , empathy , disease , action (physics) , population , dementia , social psychology , medicine , physics , environmental health , pathology , quantum mechanics
Background: Patients with degenerative dementias, especially those with frontotemporal lobar degeneration frequently develop disinhibited and inappropriate behaviors which can be hurtful to significant others and result in prominent familial and social discord. This is especially so for acts of infidelity, loss of empathy, poor vocational and financial decisions, and others. Methods: The professional working with this population of patients is frequently in a position to provide advice and support to both the patient and their significant others. The question frequently asked is the degree of culpability and the level of control the patient possesses for his or her actions, taking into account the patient’s underlying neurodegenerative disorder. I describe a method implicating a distinct approach to the patient and to significant others. To the latter, I discuss the neurobiological mechanisms for free will and freedom of choice, which may be affected in the patient. I encourage equilibrium between tolerance and expectation; tolerance for the patient’s behavior but simultaneously, a certain degree of expectation conveyed to the patient that he or she controls their behavior. To the patient I convey the expectation that despite the neurological disease, he or she has control over their actions and thus should work extra hard at exercising control. Results: I have found that this seemingly simple approach can help alleviate some of the tension in family dynamics caused by this disorder. Conclusions: In this presentation, I also discuss neurological underpinnings of free will and freedom of choice and how these attributes may be affected in patients with frontotemporal dementias.