The Intern At Work: Internal Medicine 284. Looking Beneath the Surface - An Approach to BPSD
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Jun 2, 2025 This discussion dives into the complex behavioral and psychological symptoms associated with dementia, addressing the unique challenges clinicians face. It emphasizes understanding different dementia types and evaluation strategies for effective management. The importance of tailored treatment plans is explored, balancing non-pharmacologic approaches with medication when necessary. Listeners gain valuable insights into compassionate care methods and rapid response techniques for severe agitation in patients.
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Prevalence and Types of BPSD
- Behavioral and psychological symptoms in dementia (BPSD) affect most people with dementia, causing distress and caregiver fatigue.
- BPSD includes symptoms like agitation, psychosis, depression, anxiety, and inappropriate sexual behavior, manifesting from unmet needs.
Rule Out Delirium First
- Always consider and rule out delirium when a dementia patient shows acute behavioral changes.
- Use thorough workup to identify delirium causes before attributing symptoms to BPSD.
Thorough History is Critical
- Gather history from multiple sources including caregivers to understand cognitive and functional baseline.
- Ask about symptom onset, triggers, and assess caregiver supports to tailor care plans effectively.