Dementia with Lewy bodies - Treating dementia with Lewy bodies

There's currently no cure for dementia with Lewy bodies, but treatments can help manage the symptoms.

First of all, your future health and social care needs will need to be assessed and a care plan drawn up.

This is a way of ensuring you receive the right treatment for your needs. It involves identifying areas where you may need some assistance, such as:

• what support you or your carer need for you to remain as independent as possible
• whether there are any changes that need to be made to your home to make it easier to live in
• whether you need any financial assistance

Read more about care plans.

Medication

Medication cannot stop the progression of dementia with Lewy bodies, but it can sometimes help reduce the symptoms.

Acetylcholinesterase inhibitors

Acetylcholinesterase inhibitors, such as donepezil (Aricept), galantamine (Reminyl) or rivastigmine (Exelon), may help improve hallucinations, confusion, and drowsiness in some people.

These medicines work by increasing levels of the chemical acetylcholine in the brain, which improves the ability of the brain cells to send signals to each other.

Common side effects of acetylcholinesterase inhibitors include feeling and being sick, diarrhoea, headaches, fatigue (extreme tiredness), and muscle cramps.

Other medications

Other medications that may help control some of the symptoms of dementia with Lewy bodies include:

• levodopa (a medication used to treat Parkinson's disease) can help reduce movement problems, although it can also worsen hallucinations and other psychotic symptoms, so it needs to be carefully monitored by your doctor
• antidepressants may help you cope if you have depression
• clonazepam can sometimes help improve your sleep if you experience sleep disturbances

Antipsychotics, such as haloperidol, should be avoided wherever possible, and should only be used to treat severely challenging behaviour that is putting you or others at risk of harm. This is because they can cause a range of serious side effects, including rigidity and immobility.

If antipsychotics are needed, they will be prescribed at the lowest possible dose, for the shortest possible time, by a specialist experienced in treating dementia with Lewy bodies. 

Supportive measures and treatments

In addition to medication, there are a number of therapies and practical measures that can help make everyday living easier for someone with dementia. These include:

• occupational therapy to identify problem areas in everyday life, such as getting dressed, and help work out practical solutions
• speech and language therapy to help improve any communication or swallowing problems
• physiotherapy to help with movement difficulties
• psychological treatments, such as cognitive stimulation, to help improve memory, problem-solving skills and language ability
• relaxation techniques, such as massage, and music or dance therapy
• home modifications, such as removing loose carpets and potential trip hazards, ensuring the home is well lit, and adding grab bars and handrails
• checking for problems with vision and hearing that could be contributing to hallucinations

Read more about living well with dementia.

Legal matters

If you have been diagnosed with dementia, you will need to make arrangements for your care that take into account the gradual decline in your mental abilities. This should include ensuring that your wishes are upheld if you're not able to make decisions for yourself.

You may wish to draw up an advance decision after first receiving a diagnosis of dementia. This makes your treatment preferences known now, in case you are unable to do this in the future.

You may also want to consider giving a relative lasting power of attorney. This is the power to make decisions about you if you are unable to.

Read more about managing legal affairs for someone with dementia.

Advice for carers

If you care for someone with dementia, you may find it helpful to read more about:

• respite care – this can allow you to take breaks from caring
• legal issues for carers – such as what to do when someone can no longer make decisions for themselves
• benefits for carers – such as allowances and tax credits that may be available
• looking after someone with dementia