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Med J Aust. 2003 Mar 3;178(5):231-4.

Behavioural and psychological symptoms of dementia: a seven-tiered model of service delivery.

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  • 1Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Avoca Street, Randwick, NSW 2031, Australia.


People with dementia usually experience behavioural and psychological symptoms of dementia (BPSD) during the course of their illness. Currently, in Australia, there is a lack of comprehensive planning for managing and preventing BPSD, and the resources required for optimal care are inadequate and unevenly distributed. We propose a seven-tiered model of service delivery based on severity and prevalence of BPSD, ranging from no dementia through tiers of increasingly severe behavioural disturbance to the propensity for extreme violence in a small number of individuals. Each tier is associated with a different model of intervention. People with dementia may move up or down between tiers depending on their condition, their care and the intervention provided. Lower-level interventions may prevent the need for the more intensive interventions needed when disturbance becomes more severe.

[PubMed - indexed for MEDLINE]
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