Dr. Venus Nicolino Discusses Therapies That Address Emotional and Behavioral Symptoms in Alzheimer’s Patients

There’s a higher chance than ever that you or someone you know is in the early stages of Alzheimer’s disease. One in three seniors in the United States now develops Alzheimer’s or another form of dementia. Given that reality, Dr. Venus Nicolino believes it’s more important than ever for people to understand the types of therapies available to them.

Nicolino recently offered a rundown of common therapies that can help those with Alzheimer’s disease, which now kills more people in the United States than breast cancer and prostate cancer combined. The doctor of clinical psychology and bestselling author, often called “Dr. V,” is known for her irreverent approach and “direct to the point” advice designed to help people manage common challenges.

She brings that approach to every issue, whether it’s relationship advice or dealing with a serious medical diagnosis such as Alzheimer’s disease or other forms of dementia. She said one of the most important pieces of advice those with dementia and their family members need to keep in mind is to seek professional support.

“It’s important to consult with health care professionals for personalized advice and guidance regarding cognitive health strategies, especially if you have underlying medical conditions or specific concerns,” Dr. Venus Nicolino said. “They can provide tailored recommendations based on your individual needs.”

Facts About Alzheimer’s Disease

Alzheimer’s disease is a progressive condition that kills brain cells, causing the brain to function less well as time goes on and the disease advances. While no cure exists, certain types of therapies can help improve symptoms. 

The 2023 Alzheimer’s Disease Facts and Figures report from the Alzheimer’s Association estimates that more than 6 million Americans now live with Alzheimer’s. That number is expected to reach nearly 13 million by 2050 as the population ages.

In 2023 alone, Alzheimer’s and other forms of dementia are expected to cost the nation around $345 billion, according to the report, comprising total health care and long-term care payments. That number is also expected to rise dramatically by 2050, reaching almost $1 trillion.

Dr. Venus Nicolino said that Alzheimer’s has a significant impact on families — and especially on those acting as caregivers to people suffering from dementia.

“Witnessing a loved one’s cognitive decline and personality changes can be emotionally challenging and lead to increased stress, anxiety, and depression,” Dr. Nicolino said. “Caregivers often face physical, emotional, and financial strains, as dementia care requires constant supervision, assistance with daily activities, and significant time commitments.”

Beyond the emotional costs, she added that direct financial costs associated with Alzheimer’s include medical expenses, hospitalizations, and long-term care. Dr. Nicolino also noted the indirect costs that include lost productivity from patients as well as the burden on caregivers who may need to reduce or quit their jobs to provide care.

Dr. Venus Nicolino Shares Therapy Options for Alzheimer’s Patients

Patients and families have a large variety of options to consider when looking into cognitive therapies that can address the emotional and behavioral challenges common for Alzheimer’s patients, according to Dr. Nicolino.

She said clinicians can adapt and use cognitive behavioral therapies to address behavioral and emotional symptoms in patients with Alzheimer’s disease. Although CBT primarily targets cognitive and emotional processes, it still benefits individuals with dementia by focusing on their remaining abilities and supporting their well-being. 

Some of the most common CBT-based approaches include the following, according to Dr. Nicolino.

— Reality Orientation Therapy

This approach aims to improve orientation, memory, and awareness for those with cognitive impairments. It involves providing consistent and structured cues to reinforce reality and help reduce confusion, disorientation, and frustration.

— Reminiscence Therapy

This treatment uses the act of recalling and discussing past experiences, often supported by visual aids like photographs or familiar objects. This promotes emotional well-being, encourages social interaction, and enhances a sense of identity and self-worth.

— Validation Therapy

This therapy uses empathetic communication techniques to validate and empathize with the emotions and experiences of Alzheimer’s patients, even if they may not align with current reality. The focus is on emotional support that reduces distress and enhances emotional well-being.

— Behavioral Activation

This CBT approach aims to increase engagement in positive and meaningful activities. By identifying activities that bring pleasure and a sense of accomplishment, Alzheimer’s patients can experience improved mood, reduced anxiety, and increased social interaction.

— Cognitive Stimulation Therapy. 

This approach involves structured activities and exercises to stimulate cognitive abilities and maintain mental functioning. It includes various cognitive exercises, reminiscence, problem-solving tasks, and discussions. They can enhance cognitive functioning and promote social engagement.

— Anxiety and Stress Management Techniques. 

Adapted CBT techniques for anxiety and stress management, such as deep breathing exercises, progressive muscle relaxation, and cognitive restructuring, can help individuals with Alzheimer’s reduce anxiety, manage stress, and cope with challenging situations.

Dr. Venus Nicolino added that the effectiveness of these therapies “may vary based on the individual’s specific needs, stage of the disease, and their ability to participate actively. Adaptations and modifications may be required to match the cognitive abilities and limitations of the person with Alzheimer’s.” 

She also said that involving family caregivers and providing them with education in behavioral management strategies can significantly help Alzheimer’s patients manage behavioral and emotional symptoms. It’s also important to consult with health care professionals, including psychologists, psychiatrists, and/or specialists in geriatric care.

Changes To Look for in Those With Alzheimer’s

It’s sometimes difficult, especially in the initial stages, to know for certain if someone has Alzheimer’s or another form of dementia, rather than just the normative cognitive issues that occur with age. 

Dr. Venus Nicolino has shared common red flags to look for in those who may have Alzheimer’s disease. Some of the most common symptoms include memory loss, especially frequent forgetfulness about recent events, and difficulty with problem-solving (such as managing finances or following a recipe).

They may also struggle with language and communication, searching for the right words to express themselves or frequently repeating stories or phrases. They may also get confused and disoriented, which is especially worrisome if they get lost in a familiar place.

Loved ones in the early stages of Alzheimer’s may also exhibit impaired judgment, such as repeated bad financial decisions, or frequently misplace items they commonly carry, such as keys or a phone. People may also begin to act differently, with frequently altering moods and personalities.

Dr. Venus Nicolino, a Los Angeles-based bestselling author and host of “The Tea With Dr. V” podcast, believes knowledge can help people better handle dealing with Alzheimer’s disease and other cognitive and mental health issues. She brings her own unique style to the mental health field, including in her book, Bad Advice: How To Survive and Thrive in an Age of Bulls–t. In which she offers brutally honest truths on how self-help advice from so-called “gurus” is often wrong.

Dr. V also offers advice on mental health issues through social media, including her popular TikTokand Instagram accounts. In addition, she’s the chairwoman and owner of the SoundMind app that uses music to heal trauma and improve mental health.