A national mobile advisory service has reduced dementia-related behaviours in aged care residents by half and helped to ease distress in staff, new data shows.
The government-established Severe Behaviour Response Teams (SBRT) service, which is operated by Dementia Support Australia, was established in 2015 to provide multidisciplinary support to aged care residents who are experiencing behavioural and psychological symptoms of dementia.
An analysis of 173 SBRT cases for three months found severe behaviours were reduced by 50 per cent and their severity reduced by 66 per cent. There was also a 70 per cent decrease in the level of distress in aged care workers and a slight decrease in psychotropic drug use, according to the findings.
Associate Professor Stephen Macfarlane, who is head of clinical services at DSA, presented the analysis at the International Dementia Conference in Sydney today.
He said the figures provided a strong endorsement for the SBRT approach, which involved getting to know the person and their environment, rather than writing a prescription for behavioural medication.
“The findings demonstrate we can produce massive decreases in behaviour frequencies, severity and impact on residential care providers by simply using behavioural, psychological and environmental interventions,” Associate Professor Macfarlane told Australian Ageing Agenda.
An SBRT consultant provides immediate support in the event of a crisis, including visiting the facility within 48 hours, and helps aged care workers form care plans to help manage changed behaviours in people with dementia.
“These tailored personalised interventions are effective across all domains of behavioural disturbance and we are achieving these outcomes without an increase in psychotropic drugs,” Associate Professor Macfarlane said.
Solutions in care workers’ hands
In 70 per cent of cases, pain was the undiagnosed contributing factor to changed behaviours, according to the analysis.
Untreated pain is the most common factor behind changed behaviours in cases referred to both the SBRT and Dementia Behaviour Management Advisory Service (DBMAS), which DSA has been operating nationally since October 2016.
Associate Professor Macfarlane said the data being collected through both services is providing the biggest behaviour database in the world.
It includes data on the over 6,600 DBMAS cases and 660 SBRT cases in the last 12 months alone and shows strong patterns in the types of behaviours leading to referrals and the underlying causes of those behaviours, he said.
Agitation or aggression tops referral behaviours while pain followed by carer approach top the underlying causes of behaviours, according to the data.
“Given that such a high proportion of behaviours are contributed to by pain and by the impact of an incorrect or inappropriate carer approach, the solutions to those dilemmas lie in the hands of residential [care workers],” Associate Professor Macfarlane said.
Those working with residents with challenging behaviours should conduct pain checks and optimally manage pain as a first step, he said.
The second key message is the need for all residential care workers to become familiar with the personal histories of the people that they are looking after, he said.
“If those two things alone are done by residential care that will have a significant impact on the rates of behaviour in that setting.”
DSA is funded by the Federal Government and partnered with aged care provider HammondCare.
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