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Memory loss caused by Alzheimer’s can be shocking to many caregivers, but there are other behavioral side effects, like psychosis, that can be just as frightening.

The onset of psychosis is quite common among patients with Alzheimer’s disease. More than 50% of Alzheimer’s patients experience psychotic symptoms, which led to faster functional impairment and increased mortality risk. Here are three defining factors to understand and share while educating caregivers and staff:

1. Psychotic Symptoms

The American Geriatric Society (AGS) suggests that psychosis occurring for the first time in later life is often due to dementia or neurologic conditions such Parkinson’s disease or stroke, as opposed to a primary psychotic disorder, such as schizophrenia.  Delirium that occurs as a result of dehydration, medication toxicity or pain is a common cause of abrupt behavioral health challenges in patients with dementia, and must be considered as part of the evaluation process.

  • Visual or auditory hallucinations that have been present for one month or longer
  • Delusions that are fixed, idiosyncratic or false perceptions or beliefs with little, if any, basis in reality and are not the result of religious or cultural norms
    • Examples include the belief that people are stealing things, spouse is unfaithful, etc.
  • Symptoms not continuously present before the onset of dementia

 2. Older Adult Psychosis Risk Factors

Discerning and managing psychotic symptoms among elderly patients and residents can be challenging for health care professionals and accelerate caregiver burnout.  Knowing whether the warning signs are related to Alzheimer’s or dementia, a medication reaction or potential drug interaction, or even late-onset schizophrenia, remains key in developing a comprehensive, safe treatment plan.

Here are the major risk factors for developing psychosis among elderly adults:

  • Chronic bed rest
  • Cognitive impairment
  • Female gender
  • Sensory impairment
  • Social isolation

3. Top Five Management Factors

  • Age-related pharmacokinetic and pharmacodynamic changes
  • Comorbidities and concurrent use of medications
  • Safety and efficacy issues of pharmacological treatments, such as FDA black box warnings and limited efficacy
  • Cost factors and lack of studies with adequate control group and duration of exposure for nonpharmacological interventions
  • Regulatory issues for institutionalized patients

For questions and concerns about patients or residents showing signs of psychosis, contact Oceans for support. We can help with multipronged strategies that safely and effectively optimize care for patients and their support network. 

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