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New collaboration to further staff knowledge of BPSD


A new research partnership between a university and aged care provider will give aged care staff specialised training to reduce behavioural and psychological symptoms of dementia and improve resident quality of life. 

Under the four-year study, care staff at Goodwin Aged Care will complete a detailed training program and follow a structured approach to the identification and treatment of behavioural and psychological symptoms of dementia (BPSD) with non-pharmacological interventions.

Dr Moyra Mortby, of the Centre for Research on Ageing, Health and Wellbeing at Australian National University, was awarded a $600,000 grant for the research late last year by the NHMRC-ARC Dementia Research Development Fellowships Scheme.

While the prevalence of BPSD among residents in aged care was common, staff often had different levels of training in dementia care and management, Dr Mortby told Australian Ageing Agenda.

As such, she said the research aimed to deliver a standard level of understanding of BPSD, provide better support for staff in the provision of dementia care, and in turn, improve quality of life for residents.

If successful, Dr Mortby hoped the results could lead to a national, standardised approach to care for people with dementia and BPSD.

The training program, based on an approach developed in Sweden, will focus on providing staff strategies to identify other possible causes of BPSD, such as unaddressed pain or infections.

“If you can address those conditions first, the behaviours may disappear,” Dr Mortby said.

Reducing the use of pharmacological interventions and medical treatments is a further aim, and the study would look at the use of alternative treatments such as touch therapy and massage therapy, said Dr Mortby.

As AAA recently reported, new clinical guidelines for dementia endorsed by the Federal Government have cautioned against the use of antidepressants and antipsychotics, and argued BPSD be treated with non-pharmacological interventions in the first instance.

Staff support

Dr Mortby said previous research into staff training on BPSD found that often the positive effects of interventions were unable to be sustained if not followed up regularly.

“What we really need to do is find ways of supporting care staff – especially because they’re very time poor – with methods to be able implement these interventions on an ongoing basis and maintain them over time,” she said.

In this way, the partnership with Goodwin Aged Care was vital to this research’s success, said Dr Mortby.

Goodwin operates two memory support units across its facilities. Further, executive manager of residential care Robyn Boyd said the organisation also recognises that around 85 per cent of its residents had a formal diagnosis of some form of cognitive impairment.

Ms Boyd told AAA that given rising prevalence rates, she hoped the research project would help in the development of a robust workforce equipped to provide quality dementia-specific care into the future.

“It’s not always easy to meet challenging behaviours and be successful. So we need our staff to be well-educated, well-trained and have the skill sets to be resilient in providing that care,” she said.

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8 Responses to New collaboration to further staff knowledge of BPSD

  1. Diane Simmonds April 15, 2016 at 11:47 am #

    Yes. Staff should be trained to be aware of and address the possibility of pain or infection to prevent further mental deterioration. My aunty did not know me one day when I went to visit and it turned out she had a bladder infection. Once addressed, she knew me again.

    And yes, touch (and massage) is very important to people in nursing home care, but with staff so short on time that they often cannot even give the time needed to take patients to the toilet, and to change toiletry pads every time they are used, HOW staff could/should give touch/massage TIME should be part of the study.

    Are paid professional masseurs/physio therapists to be invited into the home, and if so, who pays?

    Are family members taught and invited to massage their loved ones feet/back/hands/legs/neck/head when they come to visit? I know my father-in-law loved this when we visited him. So did my aunty.

    Are married patients encouraged to share the same bed? Sometimes they cannot even get into the same nursing home! And mostly they are put in separate rooms!

    The time factor needs to be addressed because many nursing homes are on a strict limited budget and time costs money.

  2. Kylie Wise April 15, 2016 at 3:09 pm #

    Consistent actions, non-pharmacological interventions, deal with common triggers like pain etc….I don’t see anything groundbreaking here. You can train everyone till the cows come home but if there’s not enough care staff on floor and no skilled RNs on duty it all goes down the drain.

  3. Susan Macaulay April 18, 2016 at 9:09 pm #

    @Kylie Wise is right. Knowledge is one thing, implementation is something else…

  4. Jason April 21, 2016 at 6:01 pm #

    Until we move away from the old BPSD paradigm that is mired in the medical model and focusses on therapy and ‘non-pharmacological interventions” (interesting how we continue to use the medical model language to describe even the things that are not in the medical model!!) and move to an understanding of the lived experience of dementia and create environments that nurture and nourish the person through meeting their need for well-being, we will only ever be sticking intervention based band aids on ill-being and the expression of unhappiness in people with dementia (or BPSD as the medical paradigm insists on calling it ). Now that would be something worth researching!

  5. Caroline Horlock April 21, 2016 at 9:22 pm #

    can we stop talking about interventions??? that is still band aiding the problem – we need to look at completely changing the culture of residential care – moving away from an institutional, medical model to one that resembles a regular household…a dementia friendly environment where people are well known to each other, have opportunities to do ordinary household chores (more than just folding cloths!!) routines make way for spontaneity, residents are encouraged to do as much for themselves as possible and supported where required – feelings are acknowledged as human experience rather than as a result of dementia and relationships are the priority – as they are in our own households! Allen Power – Dementia Beyond Disease says it much more eloquently than me 🙂

  6. Sarah Bucklar April 22, 2016 at 11:34 am #

    If I am feeling, sad, lonely, bored or distressed because I am living in an unfamiliar environment, where my human experience is not acknowledged but seen as a symptom of a disease, and the only way I can communicate with you is through actions / expressions, please don’t massage me – that isn’t going to work. In fact it may actually make me more frustrated, because your still not understanding that what I need is for you to try to see me, to acknowledge my experience, the whole of who I am, not just the disease that you are focussing on. I would want you to know that I want to feel like I was in a place where it felt like home, where I had friends, things to do, a purpose, meaningful moments throughout my day, where I was nurtured, encouraged and supported, where I could walk out the front door and into the garden to collect my right to sit in the sun. Train staff to understand in this way, to not see my experience of life with dementia as a symptom of a disease. Train them so that they can see beyond the disease, so that If I was in that situation, they would see me.

  7. margaret April 22, 2016 at 3:17 pm #

    So we are still going to be “treating” a cluster of “symptoms” rather than responding to each person as an individual living in an artificially constructed environment.
    We are still building 5 storey serviced apartment blocks to house people. Even when cottage respite has been shown to provide a more positive experience.

  8. Dave April 22, 2016 at 4:08 pm #

    The very nature of profit-driven residential care precludes our ability to provide the specific individual care that people with dementia need.

    Thirty caged and confused individuals pacing around the television require more skilled care than a couple of apprentice ‘lion-tamers’ on $19/hr can provide.

    Although obviously well meaning, concerns about language and labels, pharmacology, intervention strategies and the need to ‘acknowledge my experience’ (whatever that means?) inevitably lead to the next BIG IDEA and yet another blanket approach to dementia care. Witness the proliferation of hand massages, tactile boxes full of old rags and Andre Rieu DVDs on endless replay. One size will never fit all.

    And there lies the problem. We just don’t have the ability to do everything for everyone. The stages of dementia found in a typical DSU range from mild to end-stage, each individual with their own specific needs and issues, each of these occurring at various times throughout the day and each with ever changing triggers and required responses.

    … There’s plenty of clever things we can do..but what we really need is a fundamental change to the basics. Only then will we be in a position to finesse the care.

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