As FTD progresses, ritualistic and compulsive behaviors may develop, which can present as simple repetitive tendencies (clapping, snapping fingers) or more complex ritualistic activities (strict eating routines, walking specific routes each day). FTD may also cause the person diagnosed to repeat certain words or simple phrases, such as “very good” or “awesome.”

While some compulsory behaviors may be harmless and only somewhat disruptive, others, such as binge eating, can impact the quality of life of someone with FTD. Some can put the person diagnosed at risk of harm – roaming down the same busy street every day, for example.

When addressing compulsive behaviors, avoid raising your voice or trying to argue that the behaviors are wrong.

A better approach is to change the environment or routine to reduce the potential effects of harmful behaviors, or to create diversions that can help the person diagnosed avoid disruptive or harmful behaviors entirely.

If someone compulsively drinks can after can of sugary soda, raising their risk of diabetes or other health complications, try swapping the soda for a zero-sugar alternative. Sweets like candies can also be swapped for their sugarless counterparts. It may help to place food and sweets in opaque containers, making them harder to find and reducing the chance that the person diagnosed will eat compulsively.

If a loved one has a trigger for a specific compulsive behavior – for example, if they roam through the neighborhood every day after eating lunch — try diverting their attention by gently guiding them into a safer activity such as folding towels after the triggering behavior, thereby creating a new ritual for them.

In general, a daily routine may help address compulsive behaviors by creating rituals that are productive, safe, and contribute to the overall well-being of somebody with FTD. Eating, bathing, and taking part in hobbies at the same time every day can create comfort and regularity, though it is important to adjust the routine as FTD progresses to ensure that it continues to address the diagnosed person’s changing needs.

It is also important to discuss compulsive behaviors with your care team, as physicians, psychiatrists, and neurologists can help create a care plan to help address any problematic behavior. Medications like SSRIs may also be an option for addressing certain behaviors if recommended by a medical professional.

For more information on how to address compulsive behaviors, read the Summer 2012 and Winter 2015 editions of Partners in FTD Care.