In a bid to improve dementia care within the aged care sector, a new textbook for aged care workers outlines the different non-pharmacological interventions that are the best practice response to manage dementia symptoms rather than medication and restraint for people with dementia.
The textbook was launched at the International Dementia Conference 2022 in Sydney last week, aimed towards health and aged care workers and the general public.
Users will be able to learn how to address behaviours and psychological symptoms of dementia and seek to reshape the narrative in aged care homes towards understanding and seeing the person rather than their symptoms.
The 828-page book draws on international literature, research and practical experience from health and dementia care provider HammondCare for providing dementia residential and in-home care, as well as national advisory support through Dementia Support Australia.
Up to 90% of people living with dementia will experience forms of behavioural or psychological symptoms and many of them will be wrongly prescribed medications or chemically or physically restrained.
Symptoms can include psychosis, agitation and aggression, depression, anxiety, apathy, impulsivity, pacing, vocalisations, appetite and eating changes, sleep disturbances, distress during personal care, and wayfinding difficulties.
It is estimated that more than 70% of people living with dementia in residential care are prescribed at least one psychotropic medication, while about 30% are prescribed an antipsychotic.
Professor Stephen Macfarlane, Head of Clinical Services for HammondCare’s Dementia Centre, said that the medications prescribed for dementia – including antipsychotics, antidepressants, benzodiazepines, and more – are only effective in limited circumstances for dementia symptoms.
“For those agents where convincing evidence exists, the effect sizes are small, and their use is limited by significant problems with side effects,” Professor Macfarlane wrote.
Co-author of the textbook, Associate Professor Colm Cunningham, said understanding the person is the first and most fundamental step in managing care for a person with dementia.
He added every individual with dementia symptoms should have a holistic assessment done to examine all facets of a patients’ life to determine the causes of the symptoms, which could stem from undiagnosed pain, unskilled care, an unsuitable physical environment, or feelings of personal loss.
“Changes in behaviour will have many catalysts and causes, be they as a consequence of the progressive nature of the many organic conditions encompassed by the term dementia, or on too many occasions, a reasonable response to unmet needs and circumstances a person with dementia will face,” Professor Cunningham said.
The book also features more than 50 individual case studies from the frontline of dementia care to illustrate situations and care approaches that work.
HammondCare wants to see an improvement in the quality of life of people with dementia as well as the people that care for them.
For more information about the textbook, head the HammondCare website.
This book may well be interesting, but also needs to be made more accessible, including on Kindle. It needs to be priced so people can actually afford to purchase it, for example, the staff in the aged care sector are already underpaid, so how could they possible afford this?