Morris T1,2, Alford M1
1The Dementia Centre, HammondCare
2Faculty of Medicine, Monash University
Up to 90% of people living with dementia may experience behaviours and psychological symptoms of dementia (BPSD). The occurrence of BPSD can be debilitating, distressing and impair quality of life, not only for the person living with dementia but also for their caregivers.
Person-centred psychosocial interventions are the primary therapeutic approach for supporting BPSD. In Australia, this support is mainly delivered by Dementia Support Australia (DSA) programs: Dementia Behaviour Management Advisory Service (DBMAS) for people with mild-to-moderate BPSD, and Severe Behaviour Response Teams (SBRT) for people with severe BPSD. The model of care for both programs involves the identification and modification of antecedents to behaviour (e.g. the presence of undiagnosed or mismanaged pain) with an emphasis on deprescribing inappropriate medications.
This talk discusses findings from a retrospective analysis of behavioural outcomes of DSA clients in residential aged care homes in Australia and the impact such behaviours have on the wellbeing of their carers. Specifically, we analysed longitudinal changes in performance on the valid and reliable Neuropsychiatric Inventory (NPI).
The results of this investigation included 5,914 people living with dementia (55.9% female; age = 82.3 ± 8.6) residing in 1,983 aged care homes. After controlling for demographic characteristics and the impact of length of service provision, significant reductions in the severity and distress of BPSD was found, with all effects being clinically meaningful.
We discuss these results in the context of best practice in providing psychosocial interventions, and the inherent difficulties in evaluating the efficacy of multimodal and person-centred care.
Marie Alford is the Head of Dementia Centre Services. Having worked in behaviour support programs since the early Commonwealth initiatives, she led the rollout of Dementia Support Australia, a HammondCare led partnership delivering the National Severe Behaviour Response Teams, the national Dementia Behaviour Management Advisory Service and the new Needs Based Assessment Program for determining eligibility for Specialist Dementia Care Programs. Her work also includes the development of stakeholder and special needs groups strategy for DSA and the implementation of international programs. Previously heading up operations for the Dementia Centre, HammondCare she was also involved in the development of programs such as Dogs4Dementia and the launch of a range of commercial programs including international Dining and Design Schools.