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

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

Authors

Ian Andrew James

Kristina Gray

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

NICE dementia guidelines inform us that nonpharmacological treatments are first-line treatments for Behavioural and Psychological Symptoms of Dementia (BPSD). While psychotropics used to be the main treatment 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 formulations 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 (2018) guidelines too fail to provide specific guidance on which nonpharmacological approaches to use. This article argues for giving equal weight to both the collection of meaningful information and to the development of ‘informed-actions’, because it is the actions that lead to change. This paper 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 in order to provide a model with both sufficient structure and flexibility to be useful for clinicians across a range of settings and professional groups.

Citation

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

Journal Article Type Article
Acceptance Date Feb 2, 2021
Online Publication Date Mar 1, 2021
Deposit Date Feb 3, 2021
Publicly Available Date Sep 2, 2021
Journal BJPsych Advances
Print ISSN 2056-4678
Publisher Cambridge University Press
Peer Reviewed Peer Reviewed
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