Aug 30, 2017

The Common Sense Behind Behavioural and Psychological Symptoms of Dementia

Dementia is, according to World Health Organsation (WHO) defined as affecting “acquired impairment of higher mental functions, including memory, the capacity to solve everyday living problems, the performance of learned skills, the correct use of social skills, all aspects of language and the control of emotional reactions.”

Jackie Brooker, a registered nurse for many years, has worked in a number of fields and is particularly passionate about aged and dementia care, says that in reality the “definition of dementia is different for everyone”.

Brooker says she tells people that dementia is where “parts of your brain dies, and messages can no longer get through”.

Speaking at the Dementia Care Delivery Summit, Brooker talked about her experiences as a clinical nurse consultant, where she works closely with aged care staff to better understand a person who is exhibiting behavioural or psychological symptoms.

Her work primarily consists of non-pharmacological intervention for people with dementia, though she admits that in some cases such as pain, pharmaceutical interventions are used.

As she is referred to patients, “I go to the facility, I assess the person and find out what their story and then tell the staff ‘it’s common sense, guys’”.

She explains that “we” call them “challenging behaviours” because it is us who finds them challenging. We call them “difficult behaviours” because we find them difficult.

It’s important to unpack and better understand the resident to really know why they act the way they do.

One female resident, who would kick and scream every time she was placed in the chair for her outbursts, was dismissed as BPSD.

However it was later discovered that she was a survivor of Auschwitz, and that being forced to shower brought back memories of trauma.   

Once that was understood, the resident was never sent for a shower again. Instead she was bathed and she never showed aggressive behaviours towards her carers again.

Behavioural and Psychological Symptoms of Dementia, also known as BPSD come from cognitive decline.

Common symptoms are;

  • Agitation
  • Disinhibition/social inappropriateness
  • Vocal disruption
  • Depression
  • Anxiety
  • Lack of awareness
  • Mood swings
  • Sleep disturbance
  • Impulsivity
  • Apathy or lack drive and energy
  • Repetitive behaviour
  • Verbal and Physical Aggression

When these are seen in older people with dementia, these behaviors that are not “normal” are attributed to their condition. Things like banging on the dining table, or screaming when their clothes are changed.

However, Brooker explains that for the person with dementia, all they are doing is trying to communicate.

“Send me your challenging and difficult (residents) and I will show you that it is simply common sense,” Brooker says.

“These are our elders, let’s look after them they way they looked after us.”

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