Behaviour management

Changes in the behaviour of a person with dementia are very common (occurring in approximately 90% of patients). This may place enormous stress on families and carers, and can be particularly upsetting when someone previously gentle and loving begins behaving out of character. [1]

Behavioural or psychological symptoms (BPSD) include:

  • anxiety
  • delusions and hallucinations
  • depressed mood
  • apathy
  • agitation
  • aggression
  • sleep disturbance
  • wandering
  • hoarding
  • resistive to care
  • shadowing
  • inappropriate language
  • repetitive questioning
  • inappropriate toileting

Changes in behaviour may be related to these changes taking place in the brain related to dementia. In other instances, the behaviour may be in response to the person’s environment, their health or medication. [2]

The Brodaty seven-tiered pyramid model of service delivery highlights that with increasingly severe behavioural disturbance are experience by a small number of individuals. In addition the use of interventions are cumulative with the severity of BPSD, in order to manage symptoms effectively. [3]

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Changed behaviours and dementia: Help Sheet. Alzheimer’s Australia Victoria.

Behavioural and psychological symptoms of dementia: a seven-tiered model of service delivery. The Medical Journal of Australia Vol 178, March 2003

Clinical Practice Guidelines for Dementia in Australia: Recommendations 2016