Language paradigms when behaviour changes with dementia: #BanBPSD

Cunningham, Colm; Macfarlane, Stephen; Brodaty, Henry

doi:10.1002/gps.5122

Cited by 28 publications

(43 citation statements)

References 10 publications

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“…Behavioural and Psychological Symptoms of Dementia (BPSD) such as psychosis, depression and apathy have been reported to affect nearly all individuals with dementia over the course of the disease (Forester & Vahia, 2019). Regardless of the term used, it is important to understand what causes a verbal or physical behaviour and to take actions to address the person’s need (Cunningham et al., 2019; Hung et al., 2016). Responsive behaviours and BPSD often arise during care activities and may pose a safety risk to the one who requires care and those who provide care.…”

Section: Resultsmentioning

confidence: 99%

Using touchscreen tablets to support social connections and reduce responsive behaviours among people with dementia in care settings: A scoping review

et al. 2020

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The use of touchscreen tablets, such as the iPad, offers potential to support the person with dementia staying in a care setting, ranging from a long-term care home to an adult day programme. Although electronic devices are used among people with dementia, a comprehensive review of studies focusing on their impact and how they may be used effectively in care settings is lacking. We conducted a scoping review to summarize existing knowledge about the impact of touchscreen tablets in supporting social connections and reducing responsive behaviours of people with dementia in care settings. Our research team consists of patient partners and family partners, physicians, nurses, a medical student and an academic professor. A total of 17 articles were included in the review. Our analysis identified three ways in which touchscreen tablets support dementia care: (1) increased the person’s engagement, (2) decreased responsive behaviours and (3) positive effect on enjoyment/quality of life for people with dementia. Lessons learned and barriers to the use of touchscreen tablets in the care of people with dementia are described. Overall, only a few studies delineated strategies that helped to overcome barriers to technology adoption in care settings. Knowledge translation studies are needed to identify effective processes and practical tips to overcome barriers and realize the potential of assistive technology in dementia care.

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Section: Resultsmentioning

confidence: 99%

Using touchscreen tablets to support social connections and reduce responsive behaviours among people with dementia in care settings: A scoping review

et al. 2020

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“…BPSD is a term referring to a heterogeneous range of phenomena, considered to be highly prevalent and occur in the majority of people with dementia over the course of the disease (Kales, Gitlin, & Lyketsos, 2015). The term BPSD has lately been raised as controversial, and there is an ongoing discussion to find a more psychosocial term that reflects the multiple causes of behaviour in dementia care (Cunningham, Macfarlane, & Brodaty, 2019;Wolverson et al, 2019). Although we acknowledge the importance of this debate, we do not aim to take a stand in it.…”

Section: Introductionmentioning

confidence: 99%

Associations between unmet needs for daytime activities and company and scores on the Neuropsychiatric Inventory-Questionnaire in people with dementia: a longitudinal study

Michelet

Selbæk

Strand

et al. 2021

Aging & Mental Health

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Objectives: To examine prospectively the association between unmet needs for daytime activities and company and behavioural and psychological symptoms of dementia. Methods: We included 451 people with mild or moderate dementia, from eight European countries, who were assessed three times over 12 months. Unmet needs were measured with the Camberwell Assessment of Need for the Elderly. Three sub-syndromes of the Neuropsychiatric Inventory-Questionnaire were regressed, one-by-one, against unmet needs for daytime activities and company, adjusting for demographic and clinical-functional covariates. Results: Unmet needs for daytime activities were associated with more affective symptoms at baseline, six and twelve months, mean 0.74 (p < 0.001), 0.76 (p < 0.001) and 0.78 (p = 0.001) points higher score respectively, and with more psychotic symptoms at baseline (mean 0.39 points, p = 0.007) and at six months follow-up (mean 0.31 points, p = 0.006). Unmet needs for company were associated with more affective symptoms at baseline, six and twelve months, mean 0.44 (p = 0.033), 0.67 (p < 0.001) and 0.91 (p < 0.001) points higher score respectively, and with more psychotic symptoms at baseline (mean 0.40 points, p = 0.005) and at six months (mean 0.35 points, p = 0.002) follow-up. Conclusion: Interventions to reduce unmet needs for daytime activities and company could reduce affective and psychotic symptoms in people with dementia.

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“…Frequently, there are multiple factors directly and indirectly influencing the actions of the person with dementia (PwD), rather than a single cause. Cunningham et al (2019) suggest each CB has at least four contributing factors, the two most common being pain and negative caregiver interactions. People's physical health, mental health and cognitive status interact and determine how they navigate their way around their environment.…”

Section: Causesmentioning

confidence: 99%

Challenging behaviour in dementia care: a novel framework for translating knowledge to practice

James

Reichelt

Moniz–Cook

et al. 2020

tCBT

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This article provides guidance on the management of challenging behaviours (CBs) in dementia care, and introduces concepts from positive behavioural support not usually applied to dementia. While the use of formulations has received a lot of attention in recent years, the mechanisms of how to apply the formulation-led interventions requires more consideration. In order to assist caregivers to deliver effective interventions we need to have a better understanding of the CBs we are attempting to manage, and also produce management strategies with clearer goals. Ideally we would also want caregivers to be able to describe the skills they employ in a coherent manner in order to facilitate self-reflection and to be able to pass on their skills to junior colleagues. This paper attempts to fulfil these needs by integrating two new models with philosophies already used in dementia care. In terms of new concepts, the first is the Arousal Cycle, which gives caregivers an awareness of the five phases of a typical CB (wellbeing, trigger, escalation, CB, and recovery phase). In relation to the second, the Traffic Light analogy examines CBs in terms of four management stages: primary prevention, secondary prevention, reactive strategies, and calming strategies. It is proposed that we distinguish between these stages when composing our formulations and care plans, and thereby produce better targeted interventions. By the end of the paper the reader will have been presented with material integrating concepts from the fields of dementia and intellectual impairment, and been introduced to new ways of managing CBs. Key learning aims After reading this article people will: (1) Be provided with more specific guidance regarding the management of challenging behaviour (CB) in dementia; such guidance was not provided by the update of the NICE guidelines for dementia (2018). (2) Appreciate that the unmet needs perspective helps us both to understand why CB occur and to select appropriate management strategies. (3) Have an increased awareness and knowledge of new models from outside of the field of dementia. For example, through the use of the ‘arousal cycle’ people can recognise that a CB should more realistically be seen as having different phases (beginning, middle, end) rather than being perceived as a single action. (4) Be introduced to the traffic light conceptualisation which provides a useful way for guiding management strategies. (5) Be aware of when best to use resource-intensive formulations. (6) Recognise that in addition to conceptualising the person in relation to the CB, it is helpful to conceptualise the structural elements of the behaviour too. (7) Appreciate the need to help caregivers to recognise their existing skills, and to give carers the means to be able to articulate these abilities. Many care home staff currently work intuitively in the way they deliver care; as such we think they require practical frameworks and protocols to help them better elucidate what they do.

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Language paradigms when behaviour changes with dementia: #BanBPSD

Cited by 28 publications

References 10 publications

Using touchscreen tablets to support social connections and reduce responsive behaviours among people with dementia in care settings: A scoping review

Using touchscreen tablets to support social connections and reduce responsive behaviours among people with dementia in care settings: A scoping review

Associations between unmet needs for daytime activities and company and scores on the Neuropsychiatric Inventory-Questionnaire in people with dementia: a longitudinal study

Challenging behaviour in dementia care: a novel framework for translating knowledge to practice

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