Treatment - Dementia with Lewy bodies

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

Care plans

Before treatment starts, your current and future health and social care needs will 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, including whether you might need care at home or in a care home
• 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

Medicine

Medicine cannot stop dementia with Lewy bodies getting worse, but for some people it can help reduce some of the symptoms.

Acetylcholinesterase inhibitors

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

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

Common side effects include feeling and being sick, diarrhoea, headaches, tiredness and muscle cramps.

Memantine

This medicine is not an AChE inhibitor. It works by blocking the effects of a large amount of a chemical in the brain called glutamate.

Memantine is used for moderate or severe dementia with Lewy bodies. It's suitable for those who cannot take AChE inhibitors.

Side effects can include headaches, dizziness and constipation, but these are usually only temporary.

For more information about the possible side effects of your specific medicine, read the patient information leaflet that comes with it and speak to a doctor.

Other medicines

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

• levodopa – this can help with movement problems, but it can also worsen other symptoms and needs to be carefully monitored by a doctor
• antidepressants – these may be given if you're depressed
• clonazepam – this can help if you experience a particular type of rapid eye movement (REM) sleep behaviour disorder
• antipsychotics (such as quetiapine) – these may help with behaviour that's putting you or others at risk of harm, but they can cause serious side effects and should be avoided whenever possible

Support and other therapies

In addition to medicine, there are a number of therapies and practical measures that can help make life easier for someone with dementia.

These include:

• occupational therapy to identify problem areas in everyday life, such as getting dressed, and help make life easier
• speech and language therapy to help improve communication or dysphagia (swallowing problems)
• physiotherapy to help with movement
• psychological therapies, such as cognitive stimulation (activities and exercises designed to improve memory, problem solving skills and language ability)
• relaxation techniques, such as massage, and music or dance therapy
• social interaction, leisure activities and other dementia activities, such as memory cafes (drop-in sessions for people with memory problems and their carers to get support and advice)
• home modifications, such as removing trip hazards, ensuring the home is well lit, and adding grab bars and handrails

It may be helpful to get in touch with a support group, such as The Lewy Body Society, the Alzheimer's Society or Dementia UK.

Read more about living well with dementia

End of life and legal issues

If you've been diagnosed with dementia, you might want to make arrangements for your care that take into account the decline in your mental abilities.

This may include ensuring that your wishes are upheld if you're not able to make decisions for yourself.

You may want to consider:

• drawing up an advance decision, which makes your treatment preferences known in case you're unable to do this in the future
• having a plan for where you want to receive treatment as your condition becomes more advanced
• giving a relative lasting power of attorney, enabling them to make decisions about you if you're unable to

Read more about managing legal affairs for someone with dementia and end of life planning.

Help and advice for carers

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

• Looking after someone with dementia
• Carers' breaks and respite care – this can allow you to take breaks from caring
• Benefits for carers, such as allowances and tax credits that may be available