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A retrospective study of the behavioural and psychological symptoms of dementia in patients admitted to a Specialist Dementia Care Unit
Author(s) -
Djekovic Kate,
Clowes Kim,
Spalding Natasha,
Waite Louise
Publication year - 2022
Publication title -
australasian journal on ageing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.63
H-Index - 34
eISSN - 1741-6612
pISSN - 1440-6381
DOI - 10.1111/ajag.13060
Subject(s) - dementia , medicine , retrospective cohort study , aged care , emergency medicine , residential care , psychiatry , pediatrics , gerontology , disease
Objectives 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 There were 125 patients admitted over a two‐year period reviewed, with 62% being males and a mean age of 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 a 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). The mean number of psychotropic medications on admission was not significantly different to discharge ( p = 0.14). Sixty‐seven per cent 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 overall reduction in BPSD severity. This was achieved without a significant increase in the use of psychotropic medications, highlighting the importance of an individualised approach by a team skilled in the behavioural management of BPSD. The study confirms the high risk of transition to residential care for patients with BPSD.