Medicus, Vol. 29 No. 2 COVID-19, 2020.
Review article
COVID-19 and Agitated Patients with Dementia in Family Medicine Clinics
Alma Mihaljević-Peleš
Abstract
The share of the elderly in our general population, according to the report of the Central Bureau of Statistics, is over 20%. Geriatric mental health is therefore becoming an increasingly significant problem, as most elderly people live at home and are under the continuous care of general physicians. With the emergence of the COVID-19 pandemic, topped with the destructive earthquake that hit the greater Zagreb area, significant changes occurred in the lives of the elderly, as well as with those who provide them with help and care. Restriction of movement reduced the quality of geriatric care, and caused a rise in anxiety-related problems, behavioral change, and the occurrence of delirium in people with dementia, but also in the elderly who had been functioning normally until then. The causes of these conditions can vary from environmental changes, development of physical disorders, dehydration, metabolic disbalances, and deterioration associated with dementia. Depending on the sources of agitation, before the administration of medication, non-pharmacological methods should be tried, as such treatment may often be very effective. Pharmacological treatment includes two classes of drugs: benzodiazepines and antipsychotics. Croatian clinical practice differs in part from the practice of other countries due to the fact that some drugs are not available to us. For example, we do not have parenteral lorazepam on our market, but we do have diazepam and midazolam for parenteral administration, which, however, are not recommended in the elderly. Furthermore, we do not use all the antipsychotics that are available to us. For instance, we rarely use intramuscular olanzapine and ziprasidone, but we do use parenteral promazine, which is not used in other countries. Within the framework of family medicine, it is best to try home care with oral medications in small divided doses, along with the education of caregivers, on how to assess the condition and which method of care to apply. The article presents a list of recommended drugs and doses for the management of anxiety in people with demetia.
Keywords
elderly; agitated patients; dementia; family medicine; psychopharmacology; COVID-19
Hrčak ID:
244342
URI
Publication date:
30.9.2020.
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