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  • Behavioral and Psychological Symptoms of Dementia (BPSD

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    This document discusses behavioral and psychological symptoms of dementia (BPSD). It describes common behavioral symptoms like aggression, screaming, restlessness and wandering. It also lists psychological symptoms such as depressive mood, anxiety, hallucinations and delusions. The frequency of different behavioral symptoms increases as Alzheimer's disease progresses. Assessment of BPSD involves observation and patient/family interviews. Non-pharmacological approaches are recommended first for managing BPSD, with pharmacological options used if needed to prevent harm. Common non-pharmacological strategies include modifying environments, activities, communication and using distraction techniques.

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    This document discusses behavioral and psychological symptoms of dementia (BPSD). It describes common behavioral symptoms like aggression, screaming, restlessness and wandering. It also lists psychological symptoms such as depressive mood, anxiety, hallucinations and delusions. The frequency of different behavioral symptoms increases as Alzheimer's disease progresses. Assessment of BPSD involves observation and patient/family interviews. Non-pharmacological approaches are recommended first for managing BPSD, with pharmacological options used if needed to prevent harm. Common non-pharmacological strategies include modifying environments, activities, communication and using distraction techniques.

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    47 views17 pages

    Behavioral and Psychological Symptoms of Dementia (BPSD

    Uploaded by

    Chacha
    This document discusses behavioral and psychological symptoms of dementia (BPSD). It describes common behavioral symptoms like aggression, screaming, restlessness and wandering. It also lists psychological symptoms such as depressive mood, anxiety, hallucinations and delusions. The frequency of different behavioral symptoms increases as Alzheimer's disease progresses. Assessment of BPSD involves observation and patient/family interviews. Non-pharmacological approaches are recommended first for managing BPSD, with pharmacological options used if needed to prevent harm. Common non-pharmacological strategies include modifying environments, activities, communication and using distraction techniques.

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    © All Rights Reserved
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    of 17

    Behavioral and Psychological

    symptoms of Dementia (BPSD)

    Papan Thaipisuttikul
    Behavioral and Psychological Symptoms
    of Dementia
    Behavioral symptoms Psychological symptoms
    • Usually identified on the
    basis of observation : • Usually and mainly
    assessed on the basis of
    –Physical
    y aggression
    gg interviews with patients and
    –Screaming family :
    –Restlessness –Depressive
    p mood
    –Agitation
    –Anxiety
    –Wandering
    –Hallucinations
    a uc at o s
    –Culturally
    Culturally
    inappropriate –Delusions
    behaviors
    –Sexual disinhibition
    –Hoarding
    –Cursing
    C i
    –Shadowing
    Peak Frequency of Behavioral
    S
    Symptoms
    t as AD Progresses
    P
    100
    atients)

    Agitation
    80
    Diurnal
    Frequency ( % of Pa

    Rhythm
    60 Irritability
    Depression
    g
    Wandering
    Social
    Mood Aggression
    40 Withdrawal
    Anxiety Change Socially
    Paranoia Unacc. Hallucinations
    20 Suicidal
    Ideation Delusions
    Accusatory
    Sexually Inappropriate
    0
    -40
    40 -30
    30 -20
    20 -10
    10 0 10 20 30
    Months Before / After Diagnosis

    Jost BC, Grossberg GT. J Am Geriatr Soc. 1996;44:1078-1081


    Presence of BPSD in patients
    with AD according to severity of disease

    Robert P. Curr Med Research and Opinion 2002: 18, 3: 156-171


    Assessment of BPSD

    Assessment and Management of People with Behavioural and Psychological Symptoms of Dementia (BPSD), the
    NSW Ministry of Health and the Royal Australian and New Zealand College of Psychiatrists May 2013
    M
    Management
    t off BPSD
    • Non-pharmacological management
    first!
    • Pharmacological management if:
    * Harm to self
    * Harm to others
    * Unable to manage care
    Clinical Practice Guidelines in
    Thailand
    ChEI role
    l in
    i BPSD managementt
    • NICE : recommend donepezil especially
    for agitation/aggression.
    • SIGN : recommend all ChEI for BPSD in
    AD and rivastigmine for BPSD related to
    DLB, PDD.
    • NSW : All ChEI for depression/dysphoria,
    depression/dysphoria
    anxiety and apathy. Rivastigmine for VH
    and agitation in DLB
    DLB.
    • NSW : memantine for irritable, agitation,
    aggression and psychosis in AD
    AD.
    Non-pharmacological management
    f BPSD
    for
    • Maintain safety
    • Modify environments
    • Modify activities
    • Modify communication
    • Use distraction technique
    ABC assessment for BPSD
    Non-Pharmacological Rx for BPSD

    Best Practice Guideline for Accommodating and Managing Behavioural and Psychological Symptoms of Dementia in
    Residential Care.British Columbia.October 25, 2012

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