Feasibility of eye movement desensitization and reprocessing in a person with dementia and post-traumatic stress disorder: A case report

• When recognized treatment of PTSD in people with dementia should be considered. • EMDR for people with PTSD and dementia comes with challenges like the planning of shorter sessions to compensate for patients’ lower concentration and faster tiring. • EMDR for people with PTSD and dementia requires the need for shorter instructions/explanations and more repetitions due to difficulties with patients’ abstraction level, language comprehension, memory, and attention deficits. Post-traumatic stress disorder (PTSD) is an independent risk factor for dementia. Case reports of poor-moderate quality indicate the feasibility of Eye Movement Desensitization and Reprocessing (EMDR) sessions in this population but lack a detailed description of the treatment and its challenges. This report aimed to provide a detailed description of the feasibility and challenges of EMDR for a person with dementia to assist in the first step toward recognizing and treating PTSD in people with dementia. In this case study, we describe an 89-year-old nursing home resident with mild–moderate dementia and trauma related symptoms. EMDR treatment was indicated, and four sessions, according to a standard child/youth protocol, were applied. Debriefing questionnaires were completed by a psychologist after each EMDR session. To monitor the effect of the EMDR therapy, a structured interview exploring PTSD symptoms (TRADE- TRAuma and DEmentia interview) was conducted between the treatment sessions. The debriefing questionnaires showed that EMDR was well tolerated and experienced as pleasant, but some challenges occurred; During the EMDR sessions she was easily distracted, requested multiple breaks, and required the use of shorter sentences, with a more directive approach. PTSD symptoms of recurring memories and negative thoughts were reduced. This case report provides a detailed description showing the feasibility of EMDR therapy for a person with PTSD and dementia. It appeared necessary to adjust the EMDR standard child/youth protocol to a further simplified form, due to the reduced concentration and endurance.