Supporting Behavioural and Psychological Symptoms of Dementia

With the growing numbers of people living with dementia, it is anticipated we will see increased Behavioural and Psychological Symptoms of Dementia or BPSD. Most people living with dementia will experience some level of BPSD which can range from mild (apathy, repetitive behaviours) to moderate (disturbed sleep, socially inappropriate behaviour) through to severe (marked agitation, aggression)¹.

BPSD are often temporary but some can persist². A care model consistent with 10 Principles of Dignity in Care³ is proposed to minimise the impact of BPSD along with a enabling and dementia friendly environment¹. What can this look like?

There are overarching environmental design principles to guide development of physical environments to support BPSD as well as facilitating person centred care. Consideration needs to be made to size; scale; familiarity; appropriate sensory stimulation; provision of space, quiet areas; and specific activity areas with attention to gardens, noise and lighting⁴. However, these spaces need to be carefully thought out in conjunction with the care model and how the residents will be engaged. It is very complex and requires in depth collaboration, connections to current evidence base, and engaging experienced stakeholders and consultants to ensure a successful outcome. 

References:

1.     Australian Government, ‘Specialist Dementia Care Units: Consultation Paper’. 2017. Retrieved from https://consultations.health.gov.au/ageing-and-aged-care/specialist-dementia-care-units/supporting_documents/Specialist%20Dementia%20Care%20Units%20consultation%20paper%20November%202017_accessible.docx

2.     H Brodaty, B Draper and L Low, ‘Behavioural and psychological symptoms of dementia: a seven-tiered model of service delivery’, Medical Journal of Australia, 178(5), March 2003, p. 233.

3.     Guideline Adaptation Committee, Clinical Practice Guidelines and Principles of Care, op. cit. See also SA Health, Dignity in care website.

4.     Masso M, Duncan C, Grootematt P, Phillipson L, Samsa P, Fildes D, Gordon R. Specialist dementia care units: an Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Commonwealth Department of Health, 2017.