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Distressed Behaviour and Dementia Related Response

<also known as Behavioral and Psychological Symptoms of Dementia (BPSD)>

Why do people with dementia show BPSD?

BPSD is quite common among people with dementia due to physical and external causes (such as genetics, pressure, changes in daily routine, over-stimulation or environmental changes). These causes will lead to unusual behaviour, which occurs in different stages of Alzheimer’s and other types of dementia.

Commonly seen behaviours include: unwilling to communicate with other people, changes in appetite, mental disorders, being prone to anxiety and becoming emotional, sometimes showing aggressive or repetitive actions, screaming, loitering, depression, suspiciousness, delusion and sleeping disorders.

Carers can try to understand the causes of such behaviour and offer suitable responses to reduce the likelihood of misunderstanding spiralling into confrontation. Carers can record the time, place and details of such events to help analyse the behaviour’s causes and responses.

Can BPSD be treated?

Research shows that BPSD often emerges about five to six years after the onset of dementia, and the duration varies. As dementia progresses, distressed behaviour will be lessened in later stages of care.

Suitable antidepressants, antipsychotics, and antiepileptic medication may ease distressed behaviour. In general, after two to six months of treatment, doctors will reassess the medication to ascertain if it’s still needed, according to the principle of minimising drug prescriptions.

How to deal with BPSD?

Carers might feel frustrated or impatient when dealing with such behaviour; however, it is essential to communicate with them in a kind and gentle manner. Staying calm and patient is vital to avoid making the situation worse.

Local organisations specialising in caring for people with dementia (such as JCCPA) offer training courses for carers to equip them with the skills to resolve such issues. We understand the pressures that carers face, especially the challenges in dealing with distressed behaviour. We encourage carers to seek support and join counselling or support groups to learn relaxation methods and stress management. They can also use respite services to take a breather. Upon regaining their spirit and confidence, carers can handle BPSD more effectively.

Jockey Club Centre for Positive Ageing is a wholly owned subsidiary of The Chinese University of Hong Kong