Frontotemporal dementia

Physicians should discuss diagnosis, management, and prognosis with the patient, their family, and any other carers. Discussions about future care (including advance decisions) and financial matters should take place at an early stage.[120]Taylor LP, Besbris JM, Graf WD, et al. Clinical guidance in neuropalliative care: an AAN position statement. Neurology. 2022 Mar 8;98(10):409-16. https://www.doi.org/10.1212/WNL.0000000000200063 http://www.ncbi.nlm.nih.gov/pubmed/35256519?tool=bestpractice.com [121]Chiong W, Tsou AY, Simmons Z, et al. Ethical considerations in dementia diagnosis and care: AAN position statement. Neurology. 2021 Jul 13;97(2):80-9. https://www.doi.org/10.1212/WNL.0000000000012079 http://www.ncbi.nlm.nih.gov/pubmed/34524968?tool=bestpractice.com

Carers and families of patients with dementia experience significant stress that sometimes leads to depression, verbal and physical abuse of the patient, or dependence on alcohol and other drugs. This may be particularly relevant where the patient has behavioural symptoms such as aggression. It can be helpful to discuss coping techniques with carers, and they should be advised about support groups and advocacy organisations (such as the Association for Frontotemporal Dementias in the US), and other community resources that provide financial assistance, carer counselling, and respite care for the patient. The Association for Frontotemporal Degeneration Opens in new window

Younger female patients (of childbearing potential) should be informed that they must follow a pregnancy prevention programme if they are taking valproate medicines.[117]European Medicines Agency. New measures to avoid valproate exposure in pregnancy endorsed. Mar 2018 [internet publication]. https://www.ema.europa.eu/en/documents/referral/valproate-article-31-referral-new-measures-avoid-valproate-exposure-pregnancy-endorsed_en.pdf This is because valproate is associated with risk of congenital malformations and developmental problems in the infant/child.