Dementia and BPSD

Dementia and BPSD addresses behavioral and psychological symptoms—agitation, psychosis, depression, apathy, sleep disruption—through person-centred assessment and stepwise interventions. This page translates best practices into care plans: rule out pain, infection, delirium, sensory loss; adapt environments and routines; and deploy non-drug strategies before cautious pharmacology. If you’re reviewing a dementia care conference, you’ll find protocols for antipsychotic stewardship, sleep/circadian tuning, and caregiver partnership that protect dignity and safety. Because transitions and comorbid SUD occur, we cross-link to Old Age Psychiatry and SUD for medication risks and safer approaches.

Programs begin with understanding the person—their history, preferences, and triggers—then align routines, sensory inputs, and meaningful activities. Staff learn de-escalation, validation, and comfort touch; families get coaching, respite options, and crisis scripts. When medications are necessary, we use the lowest effective dose, time-limited trials, and close monitoring for falls, strokes, and QTc issues. Sleep interventions prioritize light, movement, and routine; melatonin or carefully selected agents follow if needed. Dashboards track behavior frequency, distress, and caregiver burden to guide iteration.

Person-Centred BPSD Care

Environment and routine

  • Reduce noise/clutter; increase daylight and structured activities.
  • Use cues from life history to personalize engagement.

Non-drug strategies first

  • Validation, redirection, music and movement, and gentle touch.
  • Caregiver coaching and respite reduce cycles of distress.

Medication stewardship

  • Reserve antipsychotics for severe risk; monitor closely.
  • Avoid anticholinergics; taper ineffective or harmful agents.

Assessment and reversible causes

  • Check pain, infection, constipation, dehydration, and delirium.
  • Ensure glasses/hearing aids and language access; review meds.

Services, Safety, and Supports

Caregiver partnership
Education, support groups, and crisis plans protect families.

 

Sleep and circadian
Daylight exposure, early activity, and regular routines precede meds.

Hospital and ED interfaces
Delirium prevention bundles and familiar objects reduce confusion.

Long-term care adaptations
Staff training, behavior logs, and consistent staffing teams.

Equity and culture
Culturally meaningful activities; language-matched materials.

Legal and ethics
Capacity assessments, consent, and advance-care planning.

Safety
Wandering protocols, fall prevention, and home modifications.

Outcome tracking
Behavior frequency, distress, and caregiver burden guide changes.

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