Rehabilitation to improve psychological well-being in people with dementia

Psychological well-being includes functioning within oneself and in relationships with others. People with dementia who struggle with self-identity, lose friendships, experience higher rates of depression and anxiety than others their age, and behaviors that may indicate psychological distress are common. Randomized controlled trials suggest that manualized psychological treatments (e.g., Cognitive Behavioral Therapy, Psychodynamic Interpersonal Therapy) and nonmanualized supportive counseling, individually and in groups, can promote psychological well-being in people with dementia. We present suggestions for adaptations to psychological therapies to cater to people with dementia, such as allowing more time, repetition, modeling, and written instruction, and including family care partners and professional staff when appropriate. There is limited evidence that peer support, activity-based therapeutic programs or psychotropic medications improve psychological well-being.