Systemic approach to behavioural and psychological symptoms of dementia in residential aged care facilities

Looi, Jeffrey C. L., Byrne, Gerard J., Macfarlane, Stephen, McKay, Roderick and O'Connor, Daniel W. (2013) Systemic approach to behavioural and psychological symptoms of dementia in residential aged care facilities. Australian and New Zealand Journal of Psychiatry, OnlineFirst 2: 1-4. doi:10.1177/0004867413499078

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Author Looi, Jeffrey C. L.
Byrne, Gerard J.
Macfarlane, Stephen
McKay, Roderick
O'Connor, Daniel W.
Title Systemic approach to behavioural and psychological symptoms of dementia in residential aged care facilities
Journal name Australian and New Zealand Journal of Psychiatry   Check publisher's open access policy
ISSN 0004-8674
1440-1614
Publication date 2013-07-25
Year available 2014
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1177/0004867413499078
Open Access Status
Volume OnlineFirst
Issue 2
Start page 1
End page 4
Total pages 4
Place of publication London, United Kingdom
Publisher Sage Publications
Language eng
Formatted abstract
Residents in aged care facilities are among our most frail and vulnerable citizens. In a humane society, they should be afforded comprehensive, high-quality care that explicitly addresses the known high prevalence of dementia with BPSD. This high-quality individualised care is likely to be predicated upon systematic changes in the RACF environment that go well beyond calls for a reduction in the use of psychotropic medication.

Potential proposals for systemic improvement may include:

• the provision of services for prompt assessment of residents with mental illness, such as consultation-liaison mental health services, GPs, nurses/appropriately supervised nurse-practitioners, psychologists, pharmacists and allied health professionals visiting RACFs;
• GP and specialist collaborative care with nurses/appropriately supervised nurse-practitioners, psychologists, pharmacists and allied health professionals visiting RACFs;
• the use of telemedicine and innovative technology approaches in support of the above;
• education and up-skilling of care staff to collaboratively implement personalised psychosocial/nonpharmacological interventions (including the health student teaching in RACFs and RACFs as teaching environments);
• training in the use of assessment instruments (observation scales/ questionnaires) for common mental health problems by skilled care staff;
• changes in the design and organisational culture of RACFs towards improving the mental well-being of residents;
• the investigation and development of sustainable funding models for provision of care (Hilmer and Gnjidic, 2013) to allow improved remuneration for RACF personnel, including nursing staff and GPs;
• coordination of all of the above, preferably via strong links between primary care and specialist services.

Comprehensive systemic review and reform of the provision of mental health care for BPSD within RACFs is needed to address the problem of potential overuse of psychotropic medication.
Keyword Psychiatry
Psychiatry
PSYCHIATRY, SCI
PSYCHIATRY, SSCI
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online before print July 25, 2013

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2014 Collection
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 2 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 1 times in Scopus Article | Citations
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Created: Tue, 03 Dec 2013, 20:43:14 EST by Sheila Cleary on behalf of Psychiatry - Royal Brisbane and Women's Hospital