Managing BPSD: Guide for Patients and Their Carers

Dementia refers to a group of neurological conditions that cause a progressive, widespread decline in cognitive function. It manifests differently in every individual and comes in different types. 

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The most common among them is Alzheimer’s disease. This mental deterioration frequently causes changes (which can be referred to as BPSD) in patients with dementia, causing impaired ability to interact appropriately with others and the environment.

BPSD is short for behavioural and psychological symptoms in dementia or the changes in behaviour and mood among patients living with cognitive impairment.

What are the behavioural and psychological symptoms of dementia?

Loss of intellectual function and memory are the well-known symptoms of dementia, drastically reducing the quality of life among patients. Apart from these adverse events, patients with dementia experience BPSD as well. 

Symptoms of dementia BPSD include the following:

About 90% of patients with dementia manifest these BPSD symptoms, which can be classified into five categories: 

  1. Vegetative (changes in appetite and disturbances in sleep)
  2. Verbal (yelling, calling out, verbal aggression)
  3. Motor (pacing, wandering)
  4. Emotional (agitation, apathy, depression, euphoria, irritability)
  5. Perceptual/cognitive (delusions and hallucinations)

Emotional and cognitive categories are often aggressive symptoms that need pharmacological treatment. The rest are usually triggered by environmental factors but can be managed with aged care assessment and health care support. 

In the next sections, we’ll go over the mild and aggressive behavioural symptoms of dementia BPSD and what to do to manage them.

Mild BPSD and Management

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Vegetative, verbal, and motor symptoms are often mild and manageable with aged care support. Person-centred assessment and interventions work best to manage behavioural symptoms. 

1. Sundowning (Restlessness, Confusion)

This refers to changed behaviours, restlessness, and increasing confusion in people with dementia. As the name suggests, sundowning occurs during sundown or early evening.

What To Do

2. Wandering

Although it is a mild symptom, wandering is still reported as one of the most troubling BPSD. This is because older people exhibit different patterns of wandering behaviour during assessment. There are also different levels of risk and management issues.

What To Do

Wandering Managing BPSD | My Delta Care

3. Agitation/Anxiety

These two are psychological symptoms of dementia that may be emotionally tough for patients, which is why care facilities and family members need to understand the reality the patient is experiencing and validate this. 

Psychological symptoms of dementia:

4. Sleep Disturbances

BPSD also includes sleep disturbances that can negatively affect patients’ quality of life.

What To Do 

Aggressive BPSD and How to Manage

Some psychological symptoms of dementia may be hard to manage for carers and family members. While the mild symptoms can often use a non-pharmacological approach as treatment, psychotic symptoms of dementia BPSD (delusions hallucinations) are usually treated with antipsychotics. (This approach is not free from risk.)

Aggressive BPSD and How to Manage Managing BPSD | My Delta Care

Clinical assessment is the first line of action to determine which antipsychotic drugs the patient can use for the management of BPSD.

The following are symptoms of BPSD that may be tagged as aggressive behaviour and the strategies you can apply to care for an aggressive patient.

1. Physical Aggression

This can be triggered by fatigue and an over-stimulating environment (e.g. noisy, crowded atmosphere). There are some non-pharmacological approaches you can try. 

What To Do

2. Depression

Depression can also be triggered by fatigue and an over-stimulating environment like a noisy or crowded atmosphere. Some non-pharmacological approaches should also be used to battle the side effects of antidepressants.

What To Do 

3. Vocally Disruptive Behaviour (VDB)

This behaviour can be extremely disruptive. It places other individuals at risk and often causes distress for caregivers. Unfortunately for vocally disruptive behaviour, there are no random control trials and in-depth studies yet, but several aged care approaches are being used.

What To Do 

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4. Psychosis

Neuropsychiatric symptoms also include delusions and hallucinations. Patients with dementia experience BPSD in such a way that it makes them feel fear or distress. These psychotic symptoms can present in the later stages of dementia.

What To Do

What does BPSD stand for in aged care?

With Australia’s ageing population, aged care facilities will have to care for residents showing behavioural and psychological symptoms of dementia. Assessment of a patient’s behaviour helps identify which strategies their carers and family members should use to help the patient deal or interact with the environment while managing BPSD.

Delta Care provides valuable reads in taking care of dementia patients. Browse through the website for more more information. Based in VIC, Australia, Delta Care is a care facility with a range of services for elderly residents

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