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Behavioural and psychological symptoms of dementia : a new framework for holistic understanding and non-pharmacological management

James, Ian Andrew; Gray, Kristina; Moniz-Cook, Esme; Lee, Katy; Reichelt, Katharina; Richardson, Jonathan

Authors

Ian Andrew James

Kristina Gray

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Professor Esme Moniz-Cook E.D.Moniz-Cook@hull.ac.uk
Professor of Clinical Psychology of Ageing and Dementia Care Research/ Dementia Research Work Group Lead

Katy Lee

Katharina Reichelt

Jonathan Richardson



Abstract

The National Institute for Health and Care Excellence (NICE) informs us that the first-line treatments for behavioural and psychological symptoms of dementia (BPSD) are non-pharmacological. Although psychotropics used to be the main strategy in the management of behaviours that challenge, there has been an increase in the use of biopsychosocial formulations since 2010, and there are now over a dozen to choose from. However, many are overly focused on obtaining information about the agitation, and less specific about providing details of the actions required to manage the behaviours. The NICE guidelines too fail to provide specific guidance on which non-pharmacological approaches to use. This article argues for giving equal weight to both the collection of meaningful information and the development of 'informed actions', because it is the actions that lead to change. The article outlines a management programme providing a framework for the assessment, formulation and treatment of agitation in dementia. The work draws on theory, evidence-based practice and practice-based evidence to provide a model with sufficient structure and flexibility to be useful for clinicians across a range of settings and professional groups.

Citation

James, I. A., Gray, K., Moniz-Cook, E., Lee, K., Reichelt, K., & Richardson, J. (2022). Behavioural and psychological symptoms of dementia : a new framework for holistic understanding and non-pharmacological management. BJPsych Advances, 28(1), 11-20. https://doi.org/10.1192/bja.2021.12

Journal Article Type Article
Acceptance Date Feb 2, 2021
Online Publication Date Mar 1, 2021
Publication Date Jan 6, 2022
Deposit Date Feb 3, 2021
Publicly Available Date Mar 29, 2024
Journal BJPsych Advances
Print ISSN 2056-4678
Electronic ISSN 2056-4686
Publisher Cambridge University Press
Peer Reviewed Peer Reviewed
Volume 28
Issue 1
Pages 11-20
DOI https://doi.org/10.1192/bja.2021.12
Keywords Dementia; Psychosocial interventions; Formulation; BPSD; Non-pharmacological
Public URL https://hull-repository.worktribe.com/output/3709780

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