August 29, 2016
Frontotemporal degenerations (FTD) refers to a group of disorders caused by progressive nerve cell loss in the brain's frontal and temporal lobes (the areas generally associated with personality, behavior and language), among them frontotemporal dementia.
Signs and symptoms of frontotemporal dementia vary depending upon the part(s) of the brain affected. Some people with frontotemporal dementia undergo dramatic changes in their personality and become socially inappropriate, impulsive or emotionally indifferent, while others lose the ability to use language. Several years ago, we had a client with frontotemporal dementia named Earl. He gradually lost the ability to empathize with others, made racist and sexist comments to his employees and became aggressive and callous in his interactions with others. You can read Earl’s full story here.
It’s important to encourage and facilitate the person with FTD to participate in tasks they used to perform. Engagement in even small portions of a familiar activity/task will help maintain skill and provide dignity and happiness. Since aphasia (loss of ability to understand or express speech) is common with FTD and can impact one’s ability to complete tasks, it’s helpful to limit instructions to one-step directions. Rather than saying, “Please set the table,” which may be too complex to understand at this point in the disease, you can use a technique called "task breakdown." With this technique, you break down complicated tasks into shorter, simpler steps. You might say, “Please go get the forks from the drawer.” Then, "Put the forks on the table,” followed by, “Now get the plates from the cabinet," and then, "Put them on the table.” By focusing on each individual step, using short, simple sentences, and using visual cues such as pointing, you help the person with FTD feel useful and successful.
Here in the San Francisco Bay Area, we’re fortunate to have some of the world’s leading clinicians working hard to better understand, diagnose and treat dementias like frontotemporal. UCSF’s Memory and Aging Center’s Dr. Bruce Miller explains FTD’s effect on behavior and language in this short video.
If you or a loved one are struggling with this challenging form of dementia, you’re not alone. The Association for Frontotemporal Degeneration offers some great tips on managing behaviors, ways to participate in research and resources for caregivers.
