Dementia care
Making sense of changed behaviours in dementia care
Duncan McKellar, clinical specialist with The Dementia Centre, HammondCare, discusses the behaviours and psychological symptoms associated with dementia, and outlines how people living with dementia can be correctly assessed, properly understood, and best cared for
Dementia is a global health priority. The World Health Organisation predicts that, by 2030, there will be 75 million people living with dementia worldwide. The cost of caring for people with dementia will have increased to £1.6 trillion.1
Dementia is the
second leading cause of death in the UK, surpassed recently by COVID-19, which has disproportionately impacted people with dementia.2
Recognising the significance
of this, in 2022, the UK government announced a 10-year plan to tackle the increasing challenges associated with dementia.3
But the impact of dementia is more than global statistics. Dementia personally affects the lives of individuals and their families, presenting them with multiple hurdles as they adapt to changes in daily life, relationships, and identity. People living with dementia can encounter social stigma and misunderstanding, particularly as their abilities and behaviours change and their need for support increases.4
Behaviours and psychological symptoms of dementia are common Research shows that at least 90 per cent of people living with dementia experience changed behaviours and psychological symptoms that may influence their mood, perceptions and interactions with the world around them.5
The terminology It can
be more difficult for people with dementia to communicate their needs and access health and social care. Any discussion about dementia should, firstly, acknowledge the experiences of people living with dementia and those of their families and carers.
used to describe this is ‘behaviours and psychological symptoms of dementia’, or ‘BPSD,’ in abbreviated form. This terminology refers to a wide range of symptoms and behaviours that range in severity from mild, which are common, to, more rarely, extreme symptoms, where the person finds themselves at risk of harm to themselves or someone else. Frequent symptoms and behaviours include low mood, apathy, exit-seeking from care homes, restlessness and pacing, entering other people’s personal space, defensiveness
People living with dementia can encounter social stigma and misunderstanding, particularly as their abilities and behaviours change and their need for support increases
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during personal care, disruption of sleep- wake cycles, and irritability towards other residents and care staff. Less frequently, symptoms such as severe agitation may lead to physical altercations with other residents and staff, sometimes leading to injury or damage to property.6 There is controversy over using the term ‘BPSD’ as it might appear negative. Language matters, and it is crucial that terminology does not marginalise the person with dementia or suggest that they are the cause of problems.7
Yet
behaviours and psychological symptoms can profoundly impact the person with dementia, their family, and the people who care for them, leading to distress, difficulties providing care, extended hospital stays, increased use of medications and, most importantly, reduced quality of life. Having terminology that enables clear communication so that contributing factors can be understood and supported is helpful. Sometimes, a person with dementia
may present with behaviours that express frustration or seek to communicate about an unmet personal need. Understandably,
www.thecarehomeenvironment.com May 2023
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