Kim Burns & Henry Brodaty New resources to support the management of behavioural & psychological symptoms of dementia Dementia Collaborative Research Centre www.dementiaresearch.org.au Centre for Healthy Brain Ageing www.cheba.unsw.edu.au University of New South Wales (UNSW Australia)
BPSD are common Ubiquitous, >90% of people with dementia during course YET we are not good at managing BPSD
Australian Govt funded DBMAS Dementia Behaviour Management Advisory Services Provide assistance to those caring for persons with BPSD in Residential care Community care Acute care
BPSD Guide 2012 Behaviour Management A Guide to Good Practice Managing Behavioural & Psychological Symptoms of Dementia
BPSD Guide Funded by the Australian Government Initially developed to provide guidance to DBMAS clinicians Provides practical strategies to be combined with clinical expertise Hard copy (limited) & PDF versions Demand exceeded expectations
Approach to developing BPSD Guide Systematic literature review Intervention studies rated for quality of the evidence Expert Working Group, including DBMAS clinicians Consultation with clinical experts throughout Australia
Project expanded To include additional considerations for managing BPSD in Aboriginal & Torres Strait Islander peoples + Culturally & Linguistically Diverse communities
BPSD Guide modules: A - W Behaviour management process General BPSD Aggression Agitation Anxiety Apathy Depression Disinhibited behaviours Nocturnal disruption Psychotic symptoms Vocally disruptive behaviours Wandering
Module format Key messages ½ page dot points 2 page summary Description of behaviour, case vignette Potential causes Differential Dx Measuring the behaviour Prevalence Effects on person with dementia & others
Module format cont. Results from literature search Management strategies Quality of supporting evidence for interventions: Psychosocial & environmental interventions Biological interventions Limitations of evidence Conclusions Appendices on line
Implementation - 10 in-service packages For skilled clinicians to deliver in their workplace
Each BPSD package: PowerPoint presentation with facilitators notes Lesson plan Pre & post knowledge test RN/ allied health Direct care staff Evaluation CPD certificate
Summary version of BPSD Guide A Clinician s Field Guide to Good Practice Managing Behavioural & Psychological Symptoms of Dementia Hard copy & PDF versions
Adapted summary version family carers A Guide for Family Carers Dealing with Behaviours in People with Dementia Hard copy & PDF versions
The BPSD Guide App for clinicians
Purpose of BPSD Guide App Support clinicians in the field Ready access to concise, evidence based information Prompts to guide practice Free download - itunes or Google play Search BPSD Guide
Straightforward format Search by presenting symptom OR select from submenu
For family & direct care staff Care4Dementia App Dementia behaviours carer support
Aboriginal specific resource Set of 11 BPSD posters for remote Aboriginal communities Joint project with Northern Territory (NT) DBMAS For Aboriginal health workers to leave in remote communities Posters support set of 6 short BPSD videos developed by DBMAS NT http://dbmas.org.au/resources/videos/
Evaluation of Clinicians App Evaluate effectiveness of App to support clinicians Examined clinicians experience of using the App usefulness accessibility usability Qualitative analysis - Australia wide Quantitative analysis worldwide e.g. users professional background care settings most accessed BPSD, etc
Worldwide uptake of the App
Care settings
Reinforce clinical knowledge Capacity building & education Qualitative Clinicians use of the App easy access to a point of Case management reference Validate clinicians advice
Accessibility & mobility Alternative to the large BPSD Guide Clinical scenarios Search function Clear evidence for interventions Useful aspects of the App Simple format & portability Similar structure to BPSD Guide book
Lack of access to workplace devices Limited experience with technology Evidence does not always support advice Barriers to using the App Amount of content not comprehensive enough Not for use in front of person with dementia
Future directions Translated versions of the Guide for Family Carers for CALD communities Additional considerations for managing BPSD in LGBTI people Updated version of the BPSD Guide Evaluation of a KT project using telecommunication techniques Ongoing training & dissemination of resources
Thank you www.dementiaresearch.org.au www.cheba.unsw.edu.au h.brodaty@unsw.edu.au PDF versions of resources available via our Resource Page on DCRC website http://www.dementiaresearch.org.au/bpsdguide or email k.burns@unsw.edu.au