Behavioral and psychotic symptoms of dementia: Difference between revisions

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The Association recommends training and education for both professional and family caregivers
The Association recommends training and education for both professional and family caregivers
on psychosocial interventions that might include:
on psychosocial interventions that might include:
Routine activity.
*Routine activity.
Separate the person from what seems to be upsetting him or her.
*Separate the person from what seems to be upsetting him or her.
Assess for the presence of pain, constipation or other physical problem.
*Assess for the presence of pain, constipation or other physical problem.
Review medications, especially new medications
*Review medications, especially new medications
Travel with them to where they are in time.
*Travel with them to where they are in time.
Don’t disagree; respect the person’s thoughts even if incorrect.
*Don’t disagree; respect the person’s thoughts even if incorrect.
-more
*Physical interaction: Maintain eye contact, get to their height level, and allow space.
Physical interaction: Maintain eye contact, get to their height level, and allow space.
*Speak slowly and calmly in a normal tone of voice. The person may not understand the
Speak slowly and calmly in a normal tone of voice. The person may not understand the
words spoken, but he or she may pick up the tone of the voice behind the words and
words spoken, but he or she may pick up the tone of the voice behind the words and
respond to that.
respond to that.
Avoid point finger-pointing, scolding or threatening.
*Avoid point finger-pointing, scolding or threatening.
Redirect the person to participate in an enjoyable activity or offer comfort food he or she
*Redirect the person to participate in an enjoyable activity or offer comfort food he or she
may recognize and like.
may recognize and like.
If you appear to be the cause of the problem, leave the room for a while.
*If you appear to be the cause of the problem, leave the room for a while.
Validate that the person seems to be upset over something. Reassure the person that you
*Validate that the person seems to be upset over something. Reassure the person that you
want to help and that you love him or her.
want to help and that you love him or her.
Avoid asking the person to do what appears to trigger an agitated or aggressive response.
*Avoid asking the person to do what appears to trigger an agitated or aggressive response.
In making the decision to utilize antipsychotic therapy the following should be considered:
*In making the decision to utilize antipsychotic therapy the following should be considered:
Identify and remove triggers for BPSD: pain, under/over stimulation, disruption of
:*Identify and remove triggers for BPSD: pain, under/over stimulation, disruption of
routine, infection, change in caregiver, etc.
routine, infection, change in caregiver, etc.
Initiate non-pharmacologic alternatives as first-line therapy for control of behaviors
:*Initiate non-pharmacologic alternatives as first-line therapy for control of behaviors
Assess severity and consequences of BPSD. Less-severe behaviors with limited
:*Assess severity and consequences of BPSD. Less-severe behaviors with limited
consequences of harm to individual or caregiver are appropriate for non-pharmacologic
consequences of harm to individual or caregiver are appropriate for non-pharmacologic
therapy, not antipsychotic therapy. However, more severe or “high risk” behaviors such as
therapy, not antipsychotic therapy. However, more severe or “high risk” behaviors such as
frightening hallucinations, delusions or hitting may require addition of antipsychotic trial.
frightening hallucinations, delusions or hitting may require addition of antipsychotic trial.
Determine overall risk to self or others of BPSD, and discuss with doctor the risks and
:*Determine overall risk to self or others of BPSD, and discuss with doctor the risks and
benefits with and without antipsychotics. Some behaviors may be so frequent and
benefits with and without antipsychotics. Some behaviors may be so frequent and
escalating that they result in harm to the person with dementia and caregiver that will in
escalating that they result in harm to the person with dementia and caregiver that will in
essence limit the life-expectancy and or quality of life of the person with Alzheimer’s
essence limit the life-expectancy and or quality of life of the person with Alzheimer’s
disease.
disease.
  Accept that this is a short-term intervention that must be reg
  Accept that this is a short-term intervention that must be re

Revision as of 16:37, 15 September 2012

Guidelines

The Association recommends training and education for both professional and family caregivers on psychosocial interventions that might include:

  • Routine activity.
  • Separate the person from what seems to be upsetting him or her.
  • Assess for the presence of pain, constipation or other physical problem.
  • Review medications, especially new medications
  • Travel with them to where they are in time.
  • Don’t disagree; respect the person’s thoughts even if incorrect.
  • Physical interaction: Maintain eye contact, get to their height level, and allow space.
  • Speak slowly and calmly in a normal tone of voice. The person may not understand the

words spoken, but he or she may pick up the tone of the voice behind the words and respond to that.

  • Avoid point finger-pointing, scolding or threatening.
  • Redirect the person to participate in an enjoyable activity or offer comfort food he or she

may recognize and like.

  • If you appear to be the cause of the problem, leave the room for a while.
  • Validate that the person seems to be upset over something. Reassure the person that you

want to help and that you love him or her.

  • Avoid asking the person to do what appears to trigger an agitated or aggressive response.
  • In making the decision to utilize antipsychotic therapy the following should be considered:
  • Identify and remove triggers for BPSD: pain, under/over stimulation, disruption of

routine, infection, change in caregiver, etc.

  • Initiate non-pharmacologic alternatives as first-line therapy for control of behaviors
  • Assess severity and consequences of BPSD. Less-severe behaviors with limited

consequences of harm to individual or caregiver are appropriate for non-pharmacologic therapy, not antipsychotic therapy. However, more severe or “high risk” behaviors such as frightening hallucinations, delusions or hitting may require addition of antipsychotic trial.

  • Determine overall risk to self or others of BPSD, and discuss with doctor the risks and

benefits with and without antipsychotics. Some behaviors may be so frequent and escalating that they result in harm to the person with dementia and caregiver that will in essence limit the life-expectancy and or quality of life of the person with Alzheimer’s disease. 

Accept that this is a short-term intervention that must be re
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