Behaviour Management - A Guide to Good Practice

This guide supports DBMAS clinicians in their role of assisting residential aged care facility staff, community care staff and family members caring for persons living with dementia, who present with behavioural and psychological symptoms of dementia (BPSD). A comprehensive evidence and practice-based overview of BPSD management principles is provided with practical strategies and interventions.

The guide comprises a set of modules providing behaviour specific information, including:

  • A description of the behaviour and how it presents in dementia
  • Causes
  • Differential diagnosis
  • Measuring the behaviour
  • Prevalence
  • Effects on the person with dementia and others living with them or involved in providing care
  • Results from the literature search
  • Management strategies and the quality of the supporting evidence available for specific interventions for the BPSD, such as psychosocial, environmental and biological interventions
  • Limitations of the evidence presented
  • Conclusions

Module 1: DBMAS behaviour management process

Covers the standard process for responding to and managing BPSD, including referral, risk assessment, person-centric approach to dementia care, comprehensive assessment, management plan, and consideration for Aboriginal and Torres Strait Islanders.

Module 2: General BPSD

Includes the behavioural and psychological symptoms of dementia (BPSD), interventions and effective strategies, ethical considerations, and monitoring and evaluating the impact of intervention.

Module 3: Aggression

This module looks at aggression, both physical and verbal, in dementia, and seeks to understand the causes and offer strategies for effective intervention.

Module 4: Agitation

Covers the causes and symptoms of agitation as it presents in dementia, with an examination of individual psychosocial, music, and pharmacological interventions as strategies.

Module 5: Anxiety

Emphasises the need for a multidisciplinary, individualised and multifaceted approach to anxiety, one of the most disabling and commonly occurring BPSD, and looks at medication as an intervention approach.

Module 6: Apathy

This module examines the challenges of behavioural symptoms associated with anxiety in dementia, suggests psychosocial interventions and therapeutic recreation as potential strategies, and assesses pharmacotherapy options.

Module 7: Depression

Includes an overview of depression in persons living with dementia, examines individualised psychosocial interventions, select environmental interventions and medication.

Module 8: Disinhibited behaviours

This module covers disinhibition in dementia, which presents as those behaviours associated with a reduced capacity to edit immediate impulsive responses. It addresses management of this behaviour, via behavioural-based strategies and antipsychotics.

Module 9: Nocturnal disruption

Examines the causes and symptoms of nocturnal disruption in persons living with dementia, differential diagnosis, the impact on the person and their carer, and management via behavioural and pharmacological approaches.

Module 10: Psychotic symptoms

This module covers psychotic symptoms in dementia, which present as delusions or hallucinations, and explores individual psychosocial interventions, medication, and the multifaceted care program GentleCare as behavioural management approaches.

Module 11: Vocally disruptive behaviours

Looks at causes of vocally disruptive behaviours and targets for intervention, including discomfort, operant conditioning of behaviour, and reduced-stress thresholds due to cognitive impairment.

Module 12: Wandering

Covers wandering, one of most challenging and problematic behaviours in dementia, understanding what wandering means, its adverse effects, and possible methods of intervention.