
Kate Djekovic
Geriatrician, Department of Geriatric Medicine and Centre for Education and Research on Ageing (CERA), Concord Hospital, AustraliaTitle: Behavioural and psychological symptoms of dementia (BPSD) in patients admitted to a Specialist Dementia Care Unit
Abstract
Aims: To explore the nature and severity of
behavioural and psychological symptoms of dementia (BPSD) and outcomes for
patients admitted to a Specialist Dementia Care Unit (SDCU) at a tertiary
Australian hospital.
Methods:
This single-centre retrospective study
categorised patients into a recognised seven-tiered model of severity of BPSD
using a novel tool developed for this study. Descriptive characteristics, pharmacological management, and range
and severity of BPSD were examined.
Results:
125 patients admitted over a two-year period
were reviewed, with 62% male, mean age 82.4 years. Those with high severity
BPSD (n=61, 49%) had a longer length of stay (p=0.049), were on a greater
number of psychotropic medications on admission (p<0.001), and were more
likely to be trialled on new psychotropic medication (p=0.001). At least five
behaviours on admission were demonstrated in 84% of patients. Behaviours were
ameliorated with reduction in tier severity at discharge (p<0.005). Mean
number of psychotropic medications on admission was not significantly different
to discharge (p=0.145). Sixty-seven percent of patients living independently at
admission were discharged to residential care, and 44% in residential care were
discharged to a new facility.
Conclusions: Multi-disciplinary
management led to optimisation of behaviours and reduction in BPSD severity.
This was achieved without a significant increase in use of psychotropic
medications, highlighting the importance of an individualised approach by a
team skilled in behavioural management. BPSD management should be considered
and implemented within the context of recent legislative amendments. This study
confirms high risk of transition to residential care for patients with BPSD.
Biography
Djekovic is a Staff Specialist Geriatrician at Concord Repatriation General Hospital. She received her Bachelor of Medicine, Bachelor of Surgery from the University of Notre Dame, Sydney and her Bachelor of Psychology (Honours) from Macquarie University. She completed specialty training at Concord, Royal Prince Alfred, and Prince of Wales Hospitals. She holds a Conjoint Associate Lecturer position with the University of New South Wales. Dr Djekovic’s particular interests include cognitive disorders and behavioural and psychological symptoms of dementia (BPSD).