Alternatives to (antipsychotic) medication in people with dementia

Antipsychotic medications are often prescribed for people living with dementia who display aggression or signs of psychosis (Alzheimer's Society, 2017)—however, it is estimated that these drugs are inappropriate for about two-thirds of these people (Social Care Institute for Excellence, 2015).

Imagine a patient who has dementia (or someone who you may not even know has dementia) begins shouting as you move closer to them or begins removing their clothing and touching their private parts. This may make you uncomfortable, and will likely signal that there is another issue at play if the person's dementia is not already known. It may also prompt the prescription of medications to make them easier to manage. However, outside of trying to address the behavioural symptoms, it is worth asking why this person is behaving in this way in the first place.

Could they be uncomfortable in the hospital and frightened that you are coming near them when you haven't introduced yourself, or when they can't recall you doing so? Could they be feeling warm, hence removing their clothing; or need to use the toilet, hence touching their private parts? The person may be struggling to find the words to express their unmet needs, and not simply ‘acting out’ because they are aggressive and need sedating.