Aggression prompts referral for dementia team in 95 per cent of cases

Aggression and agitation top the triggers of the 381 referrals to the new national advisory service for aged care residents experiencing severe dementia-related behaviours, a dementia conference has heard this week.

The government established the Severe Behaviour Response Teams (SBRTs) to provide a second tier of support to the existing Dementia Behaviour Management Advisory Service (DBMAS) for residents experiencing behavioural and psychological symptoms of dementia (BPSD).

The service launched nationally in November 2015 and is operated by dementia specialists HammondCare.

DBMAS staff assess an individual’s BPSD and refer severe and extreme cases to the multi-disciplinary SBRTs, which aim to respond within four hours, said Sharon Rose, Assistant Secretary Ageing Sector Support Branch at the Department of Health.

Between November 2015 and August 2016, the SBRT’s had received 381 referrals for residents exhibiting a wide range of BPSD and “early evidence is showing some excellent results,” Ms Rose told the Living Well with Dementia Conference on Monday.

“The most common BPSD triggering referrals are aggression – displayed by 95 per cent of clients – followed by agitation – displayed by 92 per cent of clients. Other triggering behaviours are anxiety, depression and dysphoria, delusions, hallucinations and psychosis,” Ms Rose said.

She said the SBRT consultants aimed to respond within four business hours and make contact with DBMAS staff, the service provider and sometimes family and relatives.

SBRTS had met the four-hour response time target in 100 per cent of the 381 referrals, provided 90 per cent with face-to-face visits within 24 hours and resolved 275 cases to date, Ms Rose said.

“The intention of these response times is to avoid the resident having to go to hospital or losing their accommodation because the provider cannot manage the situation,” she said.

In the upcoming issue of Australian Ageing Agenda magazine (September-October), Colm Cunningham of HammondCare provides an update on the SBRTs.

Call for widespread cultural change

Elsewhere at the conference, Alzheimer’s Australia NSW CEO John Watkins called for a shift in community attitudes as he launched the Living Well with Dementia discussion paper, which makes recommendations to individuals, government and aged care providers in a bid to support people with dementia to do what they enjoy for as long as possible.

John Watkins

The paper is based on surveys and interviews with people living with dementia and their family carers exploring experiences and opinions about living well and service needs. Focus groups with residential and community aged and healthcare service providers also informed the paper.

Mr Watkins said the research showed that people with dementia could live well by staying active, being supported to maintain their independence and continuing to do the things they enjoyed.

“There has to be broad societal cultural change so that when someone receives a diagnosis, they are not just written off, ignored and forgotten, which is what we so often hear,” he said.

Government investment in creating a dementia-friendly nation was crucial to achieving this cultural change, Mr Watkins said.

Among the paper’s recommendations are calls for government to invest in:

  • creating dementia-friendly communities

  • aged care programs that support psychosocial needs

  • progressing consumer directed pilots for aged care residents with dementia

  • fostering innovation that challenged residential aged care as the predominant accommodation model

For aged care providers, the paper recommends organisations:

  • foster a culture of supporting care philosophies that help people with dementia to live well, such as those that build on dignity of risk and sustaining personhood

  • provide purposeful and meaningful activities for people with dementia

  • pursue increased collaboration with consumer stakeholders to improve practices and approaches to care and support

  • use the Seven Domains of Wellbeing as a framework for case management, nursing, activities, and therapeutic and allied health practices


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