Optimising treatment and care for behavioural and psychological symptoms of dementia

Best practice guide

Alzheimer's Society has worked with the Department of Health to develop a best practice guide for health and social care professionals. The guide provides information, advice and resources for treatment and person-centred care for people with dementia experiencing behavioural and psychological symptoms.

The guide is now available to download. Charts and care plans are also available as separate downloads.

Key references are available online.

Behavioural and psychological symptoms of dementia

More than 90 per cent of people with dementia will experience behavioural and psychological symptoms of dementia. These symptoms, which include aggression, agitation and psychosis (delusions and hallucinations), can be distressing as well as presenting a real challenge for treatment.

In many cases behavioural and psychological symptoms can be prevented and managed without resorting to antipsychotic drugs. The key to achieving this is to follow the principles of good person-centred care.

Reducing the use of antipsychotic drugs

While antipsychotics do confer modest benefits in treating aggression and psychosis over 6-12 weeks, they are associated with a number of side-effects including sedation, parkinsonism, gait disturbance, dehydration, falls, chest infections, accelerated cognitive decline, stroke and death.

It was estimated in a report for the Department of Health in 2008 that 180,000 people with dementia were receiving antipsychotic drugs in the UK. Two-thirds of these prescriptions were unecessary. An audit of antipsychotic prescriptions for people with dementia (NHS Information Centre, 2012) has revealed that antipsychotic prescriptions for people with dementia have reduced by 52 per cent between 2008 and 2011.

Alzheimer's Society is working with Department of Health, Dementia Action Alliance and the Royal College of General Practitioners to support health and social care professionals in continuing to reduce the use of antipsychotic drugs in people with dementia.