Complications
Financial crisis may result from irrepressible spending or compulsive gambling. Caregivers should be counseled to limit the patient's access to money and opportunity. Referral to social work and legal assistance is recommended. It is good practice to routinely counsel patients and caregivers soon after diagnosis to take steps to safeguard financial assets.
Dangerous driving may manifest as speeding, aggressive driving, disregard of traffic rules, and accidents (or close calls) attributable to distractibility or loss of competence. In these circumstances, immediate steps should be taken to limit or revoke driving privileges.
Patients may have dependent children. Routine inquiry regarding the coping of each child, the patient's parenting, and parent-child relations is recommended. Depending on the context, counseling services and social work interventions may be needed.
Falls are frequent among patients with FTD. Cognitive impairment is associated with falls generally, but motor symptoms and signs, as seen in patients with FTD that overlaps with atypical parkinsonian disorders (e.g., progressive supranuclear palsy [PSP], corticobasal degeneration, or motor neuron disease), appear to be associated with the greatest risk. The falls rate for patients with behavioral variant FTD was reported to be 16% whereas that for patients with PSP was 90-100%.[4][141][142]
Legal trouble may result from compulsive shoplifting, reckless driving, aggressive behavior, or sexually inappropriate behavior. The physician should ensure the authorities are promptly notified of the FTD diagnosis and its relation to the incident. Urgent admission to a neuropsychiatric floor may be warranted, as may be long-term care in specialized dementia units, depending on the context.
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