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

Med J Aust. 2003 Mar 3;178(5):231-4. doi: 10.5694/j.1326-5377.2003.tb05169.x.

Abstract

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.

MeSH terms

  • Aged
  • Australia
  • Delivery of Health Care*
  • Dementia / classification
  • Dementia / psychology*
  • Dementia / therapy*
  • Disease Management*
  • Humans
  • Middle Aged
  • Patient Care Planning*
  • Psychiatric Status Rating Scales
  • Severity of Illness Index