new clinical guidelines and toolkit aim to light the way forward for those affected by dementia
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the ccsmh guidelines offer a total of 63 recommendations for managing agitation, psychosis, depression, anxiety and sexual expressions of potential risk.
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dementia patients and their healthcare providers are receiving some much-needed reinforcements courtesy of the canadian coalition for seniors’ mental health (ccsmh).
the not-for-profit organization has just unveiled a pair of invaluable resources: the canadian clinical practice guidelines for assessing and managing behavioural and psychological symptoms of dementia (bpsd) and the behaviours in dementia toolkit. the guidelines, which were created by a panel of 15 experts on the intricacies of bpsd, are informed by an extensive review of dementia research. they are complemented by the toolkit, an online library of more than 300 free resources curated to support those living with dementia-related mood and behavioural issues.
there are over 55 million people around the world currently living with dementia, including close to one million canadians. with approximately 10 million new diagnoses every year, it is estimated the number of patients worldwide will rise to 131 million by 2050. the new guidelines will help inform shared decision-making among healthcare professionals and support healthcare leaders, policymakers and researchers as they work to implement interventions that will reduce and prevent the burden of dementia.
“bpsd is something that really impacts caregivers and patients and we need to do our best to support them,” says dr. jennifer watt, assistant professor in the department of medicine at the university of toronto and co-lead of the guidelines.
good practice statements lead to compassionate care
an engagement survey that was sent to people across the country — including those living with dementia and their caregivers — helped the ccsmh determine the terminology used in the guidelines and prioritize the most pressing topics and outcomes. as a result, the five behaviour included in the project are agitation, psychosis (including delusions and hallucinations), depressive symptoms and depression, anxiety and sexual expressions of potential risk.
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“we know these symptoms are very common in people with dementia,” dr. watt says. “published literature suggests that about 75% of people living in the community will experience a symptom of bpsd in any given month. it’s higher than that in long-term care settings — more than 80%.”
the results of the survey and other research led to the development of 11 good practice statements for assessing and managing bpsd. these statements stress, among other things, the importance of obtaining consent from patients (or their caregivers) for the management of their symptoms; the need to incorporate a patient’s values and goals into treatment; and the importance of conducting a thorough evaluation to understand any biological contributors to their condition.
“these are things that we think are part of good care that needs to be done to support people with bpsd, their caregivers and the healthcare providers who are helping them,” dr. watt says.
recommendations for a better tomorrow
the guidelines offer a total of 63 recommendations for managing agitation, psychosis, depression, anxiety and sexual expressions of potential risk. the first 30 recommendations relate to agitation, which the team identified as one of the most challenging symptoms to assess and manage. all recommendations are accompanied by a strong or conditional rating along with the quality of the research upon which it was based.
“within these five topic areas, we provide recommendations around the preferred methods to diagnose and assess these symptoms,” says dr. dallas seitz, professor in the department of psychiatry at the university of calgary and lead of the guidelines. “we then offer guidance on non-pharmacological and pharmacological management. most of our recommendations received unanimous agreement from our panel.”
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a dementia toolkit for everyone
the ccsmh has also unveiled a new online library of more than 300 free resources to help address the unique needs of dementia patients. the behaviours in dementia toolkit provides a wealth of vital information in a wide range of formats, including videos, podcasts, infographics and tip sheets.
“as a healthcare provider, this toolkit allows me and colleagues to easily find resources to help us navigate the challenges we may face when supporting someone diagnosed with dementia and supporting their loved ones,” says dana human, a psychiatric nurse and regional lead of community and continuing care with southern health sante sud in manitoba.
there’s no shortage of information about dementia online but much of it is unreliable or difficult to access. the new toolkit provides user-friendly filters that make finding reliable information easy, ensuring healthcare providers and patient caregivers are able to respond to even the most frustrating of symptoms.
“most people with dementia will experience changes in their moods and behaviours,” says brenda martinussen, director of projects and public policy with ccsmh. “this toolkit is a very user-friendly resource library containing tip sheets, checklists, videos, training courses and more which help health care providers and care partners better understand and compassionately respond to behaviours in dementia.”
these guidelines are the third in a series of three sets of guidelines developed by the ccsmh in the last year, including the assessment and treatment of anxiety and social isolation and loneliness in older adults.
click here to read more about the canadian clinical practice guidelines for assessing and managing behavioural and psychological symptoms of dementia (bpsd) and the behaviours in dementia toolkit.
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