Aggression prompts referral for dementia team in 95 per cent of cases
Aggression and agitation top the triggers of the 381 people who have been referred to the new national advisory service for aged care residents experiencing severe dementia-related behaviours, a dementia conference has heard this week.
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.
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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In pursuing better practices to care and support those living with dementia it should not be forgotten that service providers and allied health professionals are not the only people in the category of carers. More and more carers will be family members and/or friends.now that CDC packages are growing in number. Care of the Carer must be an essential part of planning-making sure that during the dementia journey they receive support, education and RESPITE.. The REthink Respite project being conducted by the University of Wollongong is a wonderful example of what can be done .
The support of DBMAS is fantastic and have used this group a few times with excellent results. Reading further with regards to what Aged Care Providers can do, those on the ground/front line, we try despite the pressures put upon us. However providers are cutting costs by cutting staff to residents ratio – cutting activity staff back due to cuts in funding. Currently there is no legislation of ratio’s. How can 2 Care Staff assist anywhere from 14 to 30 people to shower, toilet, assist to feed, undertake all the necessary paperwork such as Bowel Charts, Progress Notes, Weighing etc Remember that the majority of Residents are entering Aged Care with higher care needs, which means majority are for 2 assists and can well include using hoists for transfers. Nurses also do more than their fair share of work too. Would love to spend more time with our residents, to sit, hold their hand, ease their frustrations and anxiousness, but alas this is not to be for a myriad of reasons. I hear pretty words all the time but I fail to see how this relates to the real world of what front line staff undertake.
Managing the behaviours of people who are impacted by dementia and other cognitive issues is as complex as it is diverse. One issue for me is that I am unable to video or film the best practices, processes and care models that would assist consumer, family and care staff.
Ethical restrictions here make it impossible to demonstrate a real behaviour, explain it, assessment and intervention. This is not something we can do on a manikin or in a sim lab.
If somehow we could remove this barrier then people like me can get the real education and support to empower those that need it most.