Progression of dementia symptoms in old patients because of confinement in the COVID-19 pandemic era: challenges for mental health workers and caregivers

Main Article Content

Ria Maria Theresa
Putri Nugraheni
Attaufiq Irawan
Muhammad Ariq Fiqih


dementia, confinement, covid-19 pandemic, mental health, caregivers


Currently, the whole world is experiencing a COVID-19 pandemic. The elderly are one of the populations with a high physical and mental risk of being affected by covid-19. Dementia is a psychiatric disorder that is often experienced by the elderly. We describe two cases of dementia that occurred during the COVID-19 pandemic situation. Both cases explain the condition of dementia patients during quarantine due to the implementation of the PSBB (confinement). Dementia patients have difficulty in understanding and
complying with health protocols. The emergence of exacerbation symptoms and education on health protocols are challenging for caregivers during the COVID-19 pandemic. The role of mental health workers is important to help caregivers understand the causes of worsening symptoms of dementia patients because of changes in environmental conditions during the COVID-19 pandemic situation and provide examples for caregivers on how to educate patients with appropriate health protocols. Modification of activities during a
pandemic and regular communication with caregivers can be a solution to addressing challenges.

Abstract 263 | pdf Downloads 129


1. Admin. (2020). Gugus Tugas Percepatan Penanganan COVID-19. Peta Sebaran. Gugus Tugas Percepatan Penanganan COVID-19. Retrieved
September 27, 2020, from
2. Chevance, A., Gourion, D., Hoertel, N., Llorca, P.-M., Thomas, P., Bocher, R., … Gaillard, R. (2020). Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review. L’Encéphale, 46(3), 193–201.
3. The global dementia observatory reference guide. (n.d.). Retrieved from
4. Hua, W., Xiaofeng, L., Zhenqiang, B., Jun, R., Ban, W., & Liming, L. (2020). [The epidemiological characteristics of an outbreak of 2019 novel
coronavirus diseases (COVID-19) in China]. Zhonghua Liu Xing Bing Xue Za Zhi = Zhonghua Liuxingbingxue Zazhi, 41(2), 297–300.
5. Gerlach, L. B., & Kales, H. C. (2018). Managing Behavioral and Psychological Symptoms of Dementia. The Psychiatric Clinics of North America, 41(1), 127–139.
6. Bao, Y., Sun, Y., Meng, S., Shi, J., & Lu, L. (2020). 2019-nCoV epidemic: address mental health care to empower society. The Lancet, 395(10224), e37--e38.
7. Torales, J., O’Higgins, M., Castaldelli-Maia, J. M., & Ventriglio, A. (2020). The outbreak of COVID-19 coronavirus and its impact on global mental health. International Journal of Social Psychiatry, 66(4), 317–320.
8. Migliaccio, R., & Bouzigues, A. (2020). Dementia and COVID-19 Lockdown: More Than a Double Blow for Patients and Caregivers. Journal of
Alzheimer’s Disease Reports, 4(1), 231.
9. Deardorff, W. J., & Grossberg, G. T. (2019). Behavioral and psychological symptoms in Alzheimer’s dementia and vascular dementia.
Handbook of Clinical Neurology, 165, 5–32.
10. Mukherjee, A., Biswas, A., Roy, A., Biswas, S., Gangopadhyay, G., & Das, S. K. (2017). Behavioural and Psychological Symptoms of Dementia:
Correlates and Impact on Caregiver Distress. Dementia and Geriatric Cognitive Disorders EXTRA, 7(3), 354.
11. Kales, H. C., Gitlin, L. N., & Lyketsos, C. G. (2015). Assessment and management of behavioral and psychological symptoms of dementia. BMJ (Clinical Research Ed.), 350.
12. Tible, O. P., Riese, F., Savaskan, E., & Von Gunten, A. (2017). Best practice in the management of behavioural and psychological symptoms of dementia. Therapeutic Advances in Neurological Disorders, 10(8), 297–309.
13. Ritchie, C. W. (Craig W. . (2007). Therapeutic strategies in dementia. 362.
14. Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral Sciences/clinical ... - Benjamin J. Sadock, Virginia A. Sadock, Pedro Ruiz - Google Buku.
(n.d.). Retrieved from ACAAJ&redir_esc=y
15. Suzuki, M., Hotta, M., Nagase, A., Yamamoto, Y., Hirakawa, N., Satake, Y., … Ikeda, M. (2020). The behavioral pattern of patients with frontotemporal dementia during the COVID-19 pandemic. International Psychogeriatrics, 32(10), 1231–1234.
16. Hashimoto, M., Ogawa, Y., & Ikeda, M. (2011). The impairment of abstract attitude in patients with frontotemporal lobar degeneration. Higher Brain Function Research, 31(3), 269–276.
17. Cheng, S. T. (2017). Dementia Caregiver Burden: a Research Update and Critical Analysis. Current Psychiatry Reports, 19(9).
18. Farina, N., Page, T. E., Daley, S., Brown, A., Bowling, A., Basset, T., … Banerjee, S. (2017). Factors associated with the quality of life of family
carers of people with dementia: A systematic review. Alzheimer’s & Dementia : The Journal of the Alzheimer’s Association, 13(5), 572–
19. Feast, A., Orrell, M., Charlesworth, G., Melunsky, N., Poland, F., & Moniz-Cook, E. (2016). Behavioural and psychological symptoms in
dementia and the challenges for family carers: systematic review. The British Journal of Psychiatry, 208(5), 429.
20. Brown, E. E., Kumar, S., Rajji, T. K., Pollock, B. G., & Mulsant, B. H. (2020). Anticipating and Mitigating the Impact of the COVID-19 Pandemic on Alzheimer’s Disease and Related Dementias. The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, 28(7), 712–721.
21. Padala, S. P., Jendro, A. M., & Orr, L. C. (2020). Facetime to reduce behavioral problems in a nursing home resident with Alzheimer’s dementia during COVID-19. Psychiatry Research, 288, 113028.
22. Parker, C. B., Forbes, M. P., Vahia, I. V, Forester, B. P., Jeste, D. V, & Reynolds, C. F. (2020). Facing the Change Together: Reflections of Coping and Resilience From American Geriatric Psychiatrists During COVID-19. The American Journal of Geriatric Psychiatry, 28(10), 1015.
23. Spector, A., Orrell, M., Davies, S., & Woods, B. (2000). Reality orientation for dementia. The Cochrane Database of Systematic Reviews, (2),
24. Tuffrey-Wijne, I., & Watchman, K. (2015). Breaking bad news to people with learning disabilities and dementia. Learning Disability Practice, 18(7), 16–23.
25. Ijaopo, E. O. (2017). Dementia-related agitation: a review of non-pharmacological interventions and analysis of risks and benefits of pharmacotherapy. Translational Psychiatry, 7(10).