Dementia: From Diagnosis to Management : a Functional Approach

Dementia: From Diagnosis to Management : a Functional Approach

Dementia: From Diagnosis to Management : a Functional Approach

Dementia: From Diagnosis to Management : a Functional Approach


Dementia: From Diagnosis to Management - A Functional Approachis a comprehensive description of a functional and behavioral approach to assessing and treating persons with dementia. While very practical, the information is embedded in a scientific context of the causes, neuropsychological manifestations, and complications of dementia. The management of the impairments of dementia is centered on its functional consequences and impact on daily living. The chapters describe behavioral interventions and environmental strategies that aim to improve daily activities and quality of life from a proactive communication and memory basis. Specific suggestions are provided to enhance family involvement and staff relationships, interdisciplinary cooperation, reimbursement, and documentation across various home and institutional settings.

The book is written in a straightforward style and is evenhanded in its critical analyses of the evidence available to inform practice. The extensive clinical backgrounds of the authors allow them to use 'real world' case studies to illustrate common challenges of persons with dementia and potential solutions for caregivers. Further resources and clinical materials are included in comprehensive appendices.

The volume provides essential reading for clinicians and administrators who seek to improve the lives of people with dementia and those who care for them. It is also an invaluable reference for beginning students in adult language disorders and gerontology.


Clinicians from many disciplines have been challenged to provide appropriate and effective interventions for the diverse behavioral symptoms that define the neurologically degenerative condition known as dementia. From the earliest published reference to “being out of one’s mind” at the time of the Roman poet Lucretius (50 BCE; Berrios, 1987), and even earlier reports that the ancient Egyptians (2000 BCE) observed major memory disorders to accompany advanced age (Boller & Forbes, 1998), the medical community has described changes in cognitive, psychiatric, and intellectual functioning that were not common features of aging. The first documented use of the term dementia by Philippe Pinel (1745–1826), the father of modern psychiatry, coincided with many other terms for similar behavioral symptoms including amentia, dotage, imbecility, insanity, idiocy, organic brain syndrome, and senility (Boller & Forbes; Torack, 1983). Jean Etienne Esquirol’s (1772–1840) description of dementia as “a cerebral disease characterized by an impairment of sensibility, intelligence and will” was eventually documented in the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association [APA], 1952) to describe dementia as an organic brain syndrome (OBS) that was differentiated from an acute brain syndrome due to its chronic and irreversible nature (Boller & Forbes). Subsequent editions of the DSM reflected the evolution of terminology from OBS to senile and presenile dementia to the current dementia, which is defined as “a loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning” (DSM IV; APA, 1994).

As early as the 15th and 16th centuries, the cause of “insanity” was attributed to syphilis, a disease that was thought to have been spread by Columbus’ sailors, first to Spain and Portugal, then France and Italy. Over time, the term evolved to general paresis of the insane or neurosyphilis. The late 19th and early 20th centuries brought a more precise and analytic approach to the differentiation . . .

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