The ABC of managing behavioural and psychological symptoms of dementia

The prevalence of dementia is increasing in line with the ageing of our population. Up to 90% of people with dementia display behavioural and psychological symptoms at some stage of their illness. These symptoms are often poorly managed in acute and residential care facilities despite increasing awareness and education about their management (Borbasi, Jones, Lockwood and Emden, 2006; Willick and Willick, n/d; Bird, Llewellyn-Jones, Smithers and Korten, 2002). New ways of managing behavioural and psychological symptoms of dementia (historically referred to as challenging behaviours) in acute and residential facilities are required and a simple framework for staff to use to better understand and manage these symptoms would be helpful. Method A survey was undertaken to determine the extent of challenging behaviours managed by all acute and residential aged care facilities in a rural health region and the strategies and resources with which they were managed. Results Shortcomings were found in the environment, staffing, knowledge, and policies and procedures required for best practice management. From this, the main training needs of regional nurses were identified. An education program was developed using train- the-trainer principles to enable those undertaking the training to educate their colleagues on return to their facility. The program was based on the ABC model of behaviour management, where the focus is on identifying the A (antecedent or activating event) that led to the B (behaviour) and examining the C (consequence) of the behaviour. All participants showed an increase in post-test scores compared to pre- test scores. (author abstract)