Follow-Up Care and the Caregiver's Role in Managing Agitation

This episode, "Follow-Up Care and the Caregiver's Role in Managing Agitation," features the panel closing the series with a look at follow-up ownership and the caregiver's central role in managing agitation.

The panel closes by discussing who owns follow-up once treatment for agitation begins. In one model, the psychiatric or behavioral health team manages the medication phase, coordinating timing with primary care through nurse case managers, then hands stabilized patients back to primary care regardless of whether the underlying issue is neuropsychiatric or a separate psychiatric diagnosis. Regular monitoring reports track how consistently primary care performs required movement-disorder exams for patients on antipsychotics, and when primary care remains uncomfortable continuing psychiatric follow-up, patients often return to primary care as the practical, default gatekeeper of ongoing care.

Caregiver partnership is described as central to the entire treatment approach. Caregivers should be treated as equal, or more than equal, partners, since patients often cannot reliably report their own symptoms. Panelists give caregivers plain-language behavior checklists drawn from the CMAI or NPI so that new symptoms do not come as a surprise, and so caregivers understand these behaviors stem from disease rather than anything they are doing wrong. Caregivers document how often behaviors occur and how disruptive or distressing they are, help prioritize which behaviors matter most, and continue behavioral interventions even after medication starts rather than abandoning them.

In closing reflections, the panel emphasizes that recognizing agitation as a broad, treatable syndrome, rather than a narrow set of aggressive behaviors, is the single biggest practice shift needed. They call for proactive screening at every visit from the time of diagnosis onward, reconsidering decades of off-label, black-box-labeled prescribing habits now that better-studied options exist, and treating caregivers as the true cornerstone of the care team going forward.

Thank you for watching this Psychiatric Times Peer Exchange series on agitation associated with dementia due to Alzheimer's disease. Please subscribe to our eNewsletter for information on upcoming video series.