Behavioural and Psychological Symptoms of Dementia (BPSD) is a term used to refer to a spectrum of non-cognitive symptoms and behaviours in persons living with dementia.
These changes in their mood and behaviour are often caused by a variety of factors such as the specific changes to the area of their brain affected by their condition, medical issues (i.e., pain and infection) as well as unmet needs.
These behavioural changes may be stressful, difficult to understand, and affect both the person living with dementia and those around them. Fortunately, appropriate and prompt treatment of BPSDs can significantly improve the quality of life of the persons living with dementia as well as their loved ones.
Causes of BPSDs
Persons living with dementia, like everyone else, have needs that need to be met. However, their condition may make it more challenging for them to identify, meet or communicate their physical, psychological, social, and environmental needs.
Behavioural changes can also occur as a result of changes in their brain. More specifically, the type of behaviour change is dependent on the area of the brain affected by the condition causing the person’s dementia as well.
Find out more about the potential causes and types of behavioural changes here.
Managing BPSDs
The management of BPSDs consist of conducting an assessment of the BPSDs, introducing non-pharmacological and/or pharmacological measures, and supporting the needs of everyone affected by these behavioural changes.
Generally, non-pharmacological measures such as psychosocial interventions (e.g., music therapy, art therapy) are usually the first-line approach before medication treatment is considered.
Here is a list of resources specially curated for care professionals who play a role in caring for persons living with dementia who present with BPSDs:
Case Scenarios on Managing Behaviours of Concern
Source: Agency for Integrated Care
Case Scenarios on Managing Behaviours of Concern is a resource for case workers supporting clients with mental health needs and their caregivers. This booklet comprises 11 sample case scenarios with suggestions on how you can manage cases with behaviours of concern in the community.
Tips for Engaging Resistant Clients
Source: Agency for Integrated Care
Engaging Resistant Clients comprises a total of 3 case scenarios aimed at helping mental health/dementia care professionals cement learning concepts and demonstrate application of skill.
This video covers the following points:
- Setting and managing boundaries
- Refusal to participate in activities
- Refusal to take medication
Tips for Conflict De-escalation
Source: Agency for Integrated Care
De-escalating Conflicts comprises a total of 3 case scenarios aimed at helping mental health/dementia care professionals cement learning concepts and demonstrate application of skill.
This video covers the following points:
- Hallucination, agitation and suspicion
- Aggressive behaviour
- Suicidal ideation and self-harm
The Clinician’s Field Guide to Good Practice
Source: Dementia Collaborative Research Centre
The Clinician’s Field Guide provides easy access to key messages, BPSD descriptions, potential causes and brief clinical scenarios to guide assessment and management strategies.
Psychosocial Interventions & Dementia
Source: Fondation Médéric Alzheimer
Psychosocial Interventions & Dementia is a guide intended for all professionals working directly or indirectly with persons living with dementia. It aims to improve knowledge and understanding of psychosocial interventions implemented to maintain and/or improve cognitive, psychological, social and physical functioning and, more globally, the quality of life of persons living with dementia.
UCLA Health – Dementia Care
Source: UCLA Health
The Multicampus Programs in Geriatric Medicine and Gerontology (MPGMG) at the David Geffen School of Medicine at UCLA created a series of videos on understanding and managing behaviours associated with dementia.
Every video scenario shows:
- The common response that family caregivers give in order to manage the behaviour change exhibited by their loved ones living with dementia;
- An expert’s explanation about the behaviour change, with tips to identify and minimise the triggers and suggestions for redirection; and
- The recommended response (incorporating the tips) that family caregivers can show instead to better manage the behaviour change.
This site also provides a Take Action worksheet that allows care professionals to record what they can do to minimise the triggers of the behaviour changes.
For more resources that target specific BPSDs, click here