Explain frontotemporal dementia diagnosis and plan to patient and partner — CASC communication station

Open and agenda-set. Greet both; acknowledge how exhausting and frightening the changes have been for the family. Ask their main questions first (blame, bipolar label, "is it Alzheimer," driving, children/genetics). [3]

Explain diagnosis. "This is a brain disease called behavioural variant frontotemporal dementia. It mainly affects circuits that control social behaviour, motivation, and empathy, so people can say hurtful things or make impulsive decisions without the usual brakes — it is not simply choosing to be unkind. Memory tests can still look fairly good early on, which is why this is often mistaken for a midlife psychiatric problem. We use clinical criteria and scan patterns to support the diagnosis."[1][2][3]

Explain care. "There is not yet a tablet that stops the disease the way antibiotics stop infection. The most helpful steps are structure at home, simplifying decisions, protecting finances and driving when unsafe, and supporting you as the carer. Sometimes a serotonergic medicine is tried for compulsive or irritable behaviours — for example a low-dose SSRI — with clear goals and side-effect monitoring. Alzheimer cholinesterase inhibitors are usually not the right first treatment for this pure behavioural form. Strong tranquillisers (antipsychotics) are reserved for dangerous aggression because they can increase risk of harm in people with dementia and are not a cure."[3][4][6]

Genetics. "Because there is possible motor neuron disease in the family, we may offer genetic counselling and testing for genes such as C9orf72 that can link FTD and ALS. This is optional, needs careful discussion, and has implications for relatives — we will not rush a blood test today without that support."[5]

Close. Summarise, written information, carer support contacts, driving advice process, follow-up, teach-back. [3]