Can a person with dementia be treated for a personality disorder?

[MonP]

My father has dementia, which (I think) is exacerbated by having a personality disorder. Can he be treated for this, or does his dementia prevent this? Has anyone had experience of the two problems.

[Former-Member]

Hello @MonP 

Dementia can complicate the treatment of any medical condition.  Even in those without a mental health diagnosis, behaviours and personalities change. I do not know if a PD contributes to the risk of developing what are seen as the more challenging aspects of dementia. 

Clear communication in relation to the treatment of any medical condition is necessary - not just psych,  do you have medical POA? Medication reviews are often helpful to ensure no untoward interactions between prescribed meds.  There is a lot of controversy about the use of antipsychotics in patients with dementia (most carry a black box warning for use in the elderly) and these are the RANZCP guidelines.

https://www.google.com.au/url?sa=t&source=web&rct=j&url=https://www.ranzcp.org/Files/Resources/Colle...

Help and support is available through Dementia Australia, their website has some excellent information as well as carer support options.

https://www.dementia.org.au

Is it BPD or another PD your father has? The following is a link to nhmrc guidelines regarding the treatment of BPD.

https://www.google.com.au/url?sa=t&source=web&rct=j&url=http://bpdfoundation.org.au/images/mh25_bord...

[Former-Member]

My dad has dementia. Recently with his senior Gerontologist, he diagnosed dad with depression, filled out a script for antidepressant BUT asked me to wait 2 weeks to see if dad improved with extra time outside in the sun, BECAUSE antidepressants can make the dementia worse and affect coordination (falls risk).  I say this because a lot of personality disorders are treated with antidepressants.

[Former-Member]

Hi @MonP,

Just checking-in to see how your dad and you are going.  How have you gone with being able to diagnose and treat your dad who has dementia for a potential personality disorder?

Hopefully, you've been able to hear others experiences around treating such dual diagnoses!

Kindest,

Amour_Et_Psyché

[MonP]

Unfortunately no. My father is in a nursing home; I wrote a long email to the geriatrician servicing the home and assumed he'd be in touch before he saw my father (and me) in an official appointment. A week or so later, the nursing home informed me that the geriatrician had come in to see dad and prescribed an anti-psychotic. I wasn't contacted at all. Needless to say I'm not at all happy with the treatment.

[Former-Member]

@MonP

Are you your father's enduring guardian?

[MonP]

Yes, along with my brother.

[Former-Member]

@MonP

If you are the guardians, the geriatrician is obliged to liaise with you. Do you know if your brother was contacted? Additionally if any medication is prescribed "off-label" specific informed consent should have been obtained where risks vs benefit are clearly explained  (see attached guidelines). 

If your brother was not contacted, I would be seeking an urgent appointment with the geriatrician so that the appropriateness of any medication can be discussed with a view to either accepting or declining the treatment. 

https://www.google.com.au/url?sa=t&source=web&rct=j&url=http://www.catag.org.au/wp-content/uploads/2...

[MonP]

Thank you; I'll contact geriatritian asap.