Critical Analysis of Management of BPSD in Acute Psychiatry: Report

This report presents a critical analysis of the management of Behavioral and Psychological Symptoms of Dementia (BPSD) within the context of acute psychiatry. The introduction highlights the increasing prevalence of dementia and the significance of BPSD management, emphasizing the impact on patients, clinicians, and families. The discussion delves into the symptomatic representation of dementia, etiological factors, and diagnostic procedures for BPSD. It emphasizes the importance of family involvement in patient care and the need for accurate diagnosis to guide effective interventions. The report explores both pharmacological and non-pharmacological strategies for managing BPSD, including the use of clinical measures, family-directed encouragement programs, and the treatment of comorbidities such as delirium. The analysis underscores the need for a comprehensive approach that considers various contributing attributes and treatment measures to optimize outcomes for patients.

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CRITICAL ANALYSIS ON MANAGEMENT OF BPSD
(BEHAVIOURAL AND PSYCHOLOGICAL SYMPTOMS OF
DEMENTIA) IN ACUTE PSYCHIATRY

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Table of contents
Introduction......................................................................................................................................3
Discussion........................................................................................................................................3
Conclusion.......................................................................................................................................9
References......................................................................................................................................10

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Introduction
There is the incidence of the continued rise in the number of elderly population in every country
of the world. It is naturally creating the chance of developing the symptoms and the behavior that
indicate of psychological disorders. Dementia is observed to be one of the most common and
frequently occurring psychological manifestations (Preuss, Wong & Koller, 2016). This
incidence rate had automatically fostered the increasing relevance of management of behavioral
and psychological symptoms of dementia (BPSD). It is not just alarming for the clinicians but
also equally relevant for the families of the people affected with such disordered manifestations
(Legere et al. 2018). Carla Patricia Freeman is one of the eminent personalities concerning the
field of Psychiatry and Mental Health increased alert is shown in her reports. More than 35
million of the population is found to be located in different regions of the world that are affected
with dementia. However, this prediction is found to get enhanced with time (von Gunten,
Schlaefke & Überla, 2016). The number of people affected is getting enhanced to about 115
million as predetermined by the year 2050. Behavioral and psychological symptoms of dementia
(BPSD) are found to be commonly occurring among 70% to 90% of the population (Regier &
Gitlin, 2017). The economic costs, the caregiver burden, health-related costs, premature
placements within the nursing home and the detrimental quality of lives are found to be led as
consequences for Behavioral and psychological symptoms of dementia (BPSD). The
consequences and the results manifested due to the high rate of incidence of Behavioral and
psychological symptoms of dementia (BPSD) are heinous. The level of cognition is undergoing
decline, and the disease is found to progressively lead towards deterioration. It shall become
natural to develop the symptoms of Alzheimer's dementia (AD) (Sampson et al. 2015).
Recognition in the process of Behavioral and psychological symptoms of dementia (BPSD) shall
encompass the pivotal aspect of management through patients. The clinicians are developing the
approach through syndrome towards management and incorporation of pharmacological and
non-pharmacological means and strategies.

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Discussion
When a clinical outlook is created regarding dementia symptoms varied dimensions are
possible to be taken into the paradigm of discussion:
Behavioral and psychological symptomatic representation of dementia:
Dementia is the process of psychologically categorized disease whereby the central attribute is
delineated to be the representation of cognitive impairment. There are multiple dimensions
adhering to which the brain processes are found to get disrupted. It is adhering to the disorder
that varied neuropsychiatric symptoms are taken into consideration (Jessop et al. 2017). It is
under the umbrella term of Behavioral and psychological symptoms of dementia (BPSD) that the
neuropsychiatric manifestations are vividly observed and depicted. It is through the delineated
perceptual paradigm, the thought contents, and the mood orientation that the behavior of the
affected beings is found to get channelized (McConnell & Karel, 2016). It is the category of
patients affected with dementia having Neuropsychiatric symptoms that are included within
Behavioral and psychological symptoms of dementia (BPSD) classification. They are typically
understood to show the characteristics of disturbances in their mood, thought processes, the
content of their thinking and the behaviors automatically get disrupted (Jennings et al. 2017).
Such affected individuals are most often found to depict experiences that are varied in
symptomatic representation. There might be a combination of symptoms prominent within the
individuals. This aspect is likely to differ among people according to the stage of the illness one
is passing through. Patients having greater severity are terms of dementia are found to be most
correlated with obtaining a very low score when administered with the Mini-Mental State Exam
(MMSE) (Lorusso & Bosch, 2017).
When critically analyzing the dementia factors the manifestations of visual hallucinations that
are found to be reported from patients affected with patients of this severity. In the case of
having Lewy Body Dementia, the traits of developing hallucinations are found to be more
common. Such dementia is often late to be diagnosed by the clinicians (McCausland et al. 2018).
There are often misleading treatments that are tried to be carried on by considering the dementia
manifestation as the characteristics of psychosis and schizophrenia. It is through other causative

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agents who are determined through other administrations that the final decision of verdict is
specified by the clinician.
An etiological manifestation of BPSD:
If the subsequent emphasis is necessary to be laid upon the management of Behavioral and
psychological symptoms of dementia (BPSD), the necessary protocol shall be initiated. As the
starting phase of the diagnosis, the characteristics shall encompass the determination of the
causes or etiological classification (Yoshida et al. 2017). It is reflecting upon critical aspects that
the causative agents for patients in whom the traits of BPSD are prominent the context of
dementia needs to be proven strongly. It might require developing an in-depth study to gather
knowledge about the direct results that are caused by the person reporting as a consequence of
the disorder. The progress procedure and the extent of aggravation tracking the disease shall be
endowed as the possible consequence of the disorder developed (Feast et al. 2016). There are a
pain, systemic infections, electrolyte disturbances, dehydration and constipation symptoms noted
in case of biological manifestation of BPSD. It can be found that there is a fundamental trait of
exaggeration of the pre-morbid state of wellbeing and the personality traits which encompass
severe instances of grief, depression caused due to multiple losses and sufferings in life (Bürge et
al. 2017). The environmental etiological identification is also found to take a strong position
where the changes in caregiving are the components that can result in such symptomatic
representations. There is significant impairment in the form of languages, and the severe cases of
disruption are prominently felt in this context. The gaps in links of through processes are likely
to render with patients being unable to communicate the etiological representation of the distress
they undergo there are subsequent leading changes which manifest in the form of behavioral
disturbances (Bjerre et al. 2017).
Establishing diagnostic determination for BPSD:
One of the most eminent means in which the process of management of patients suffering from
Behavioral and psychological symptoms of dementia (BPSD) shall be conducted is through
accurate intervention. The process of management operation created through clinician's
intervention is solely directed towards the process of diagnosis to be carried out effectually.
There is the number of aligned clinical measures that are necessary to be taken place with

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specific direction to dementia which can aid in designing the diagnosis of BPSD (O'connor et al.
2018). While carrying out the diagnosis, it can be critically analyzed that the intervention plan is
targeted towards dementia diagnosis, the account to be useful method in guiding the range of
potential BPSD determination process. There is a range of potentials for individuals to develop a
severe level of BPSD (Fleiner et al. 2017). The attributes of are giving provided through
monitoring the clinician's definite amount of efficiency in the treatment procedure are possible to
be brought to the place. The Alzheimer's disease rating scale shall be necessary to be
administered towards the individual towards such manifested symptoms. The score received
against such a scale shall enable the process of diagnosis, and subsequent treatment shall be
endured (Streater et al. 2017). The Cornell scale of depression along with Cohen-Mansfield
agitation inventory shall be formulated towards the patients so that effective effects can be
manifested.
Significance of involvement of family members:
A subsequent family directed encouragement program is possible to be communicated and
involved to understand, observe and monitor the continued behavioral manifestation of the
patients. The 24 hours report adhering to that client shall be received only from the close kinship
members and the family networks. This shall create a significant impact on the medical
intervention process to enable the clinician to orient the pattern of diagnosis in a definite order
(Walsh et al. 2016). The nitty-gritty regarding the daily activity and regime chart shall give a
holistic report about the client. For instance, the time is taken by the clients to bathe himself or
herself, the interest shown in eating different tastes of cuisine and food items are significant and
prominent precursors which enable in orienting the direction of the intervention process (Tampi
et al. 2017). While critically analyzing it can be found that during the time of pre-diagnosis and
the also during the span of diagnosis keeping each of these points into note shall enable the
clinician to shape the diagnosis process effectually. Once the diagnosis is established and
implemented the targeted symptoms are made to be directed so that the best possible outcomes
are possible to be shaped and yielded. The most effective treatment is then possible to be devised
by the clinician or neuropsychiatric professional who shall ensure maximum optimized outcomes
for the patients (Ryan et al. 2018). The course of the treatment is found to be tracking a definite
strategic orientation so that the chances of enduring pitfalls are also analyzed effectually. Hence

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communication with the family members is significant in both ways. Just as it enables the
professional clinician to be gathering relevant information about the client, the family members
are also able to gain updates about the current health condition of the patient. It is undergoing the
effective transparency measure through open end communication that such a two-way process of
treatment experience is possible to be generated towards patients affected with dementia at a
serious stage causing BPSD (White et al. 2017).
Management of Behavioral and psychological symptoms of dementia (BPSD):
There are multiple underlying contributing attributes that significantly align along with the
management process of Behavioral and psychological symptoms of dementia (BPSD) (Tible et
al. 2017). There are several forms of physiological illnesses that are derived in the form of co-
morbidities along with the pivotal symptomatic representation of Behavioral and psychological
symptoms of dementia (BPSD). One among them is the most significant one recognized as
delirium (Chen et al. 2018). The relevant and related psychological causative factors emerging
from factors such as environmental changes help in deriving co-morbidities within the affected
person. There are significant characteristic features that are understood as the onset of
fluctuation, confusion, sun-downing and systemic disturbances as the typical form of mental
state manifestation. However, when the state of delirium is investigated within the affected
individual, in most cases there are evidence of drug-induced consequences created. The drug-
induced forms of delirium are found to be established in the form of anticholinergics,
antipsychotics, and the antihypertensives. There are often found a significant difference existing
between the treatment measures and procedures encompassing the people affected dementia and
that in the case of delirium. However, the optimum level of effectiveness is possible to be
derived when different diagnosis measures are put to action for addressing the serious issues of
Behavioral and psychological symptoms of dementia (BPSD).
There are several noteworthy longitudinal studies carried out keeping in relevance with patients
manifesting Behavioral and psychological symptoms of dementia (BPSD). Most of these
symptoms that are exhibited according to Behavioral and psychological symptoms of dementia
(BPSD) are likely to get passed on following the intervention period of merely few months
(Anand et al. 2017). However, there are significant themes characterizing the symptoms of
dementia were agitation, aggression, psychosis, and depression that are found to be most

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prominently prevalent. In such symptomatic remission, there are mere resolutions undertaken
without significant treatment or clinical intervention being taken.
Nonpharmacological measures of managing strategies towards Behavioral and psychological
symptoms of dementia (BPSD):
There are certain management techniques that are non-pharmacological in orientation. As the
cases are specially handled under the intervention field merging between neuropsychiatric
interventions, relevant treatments are processed. In the case of addressing patients affected with
Behavioral and psychological symptoms of dementia (BPSD), the foremost intervention method
that is thought to be adopted is non-pharmacological treatment (Abraha et al. 2017). There is
employment taking place regardless of the decisions being finally posed taking further steps
towards commencing the medical procedures. It is, therefore, following the routine of
assessment, monitoring, and analysis that the needed interventions are undertaken on a regular
basis by the clinicians.
Pharmacological treatment of Behavioral and psychological symptoms of dementia
(BPSD):
There is a modest amount of individuals having dementia which are required to be addressed
with a significant amount of treatment (Diaz-Gil et al. 2018). These treatment measures are
necessarily oriented in the pharmacological dimension so that effectual treatments with
subsequent results can be produced in context with BPSD. The varied behavioral disruptions and
disturbed functions manifested antipsychotic drugs are found to be the conventional measures of
pharmacological treatment. It is well accepted as the management process so that the recent Food
and Drug Administration (FDA) shall be helpful for assessment (Honda et al. 2016). The risk of
confusions related to dementia treatments is possible to be negated with the intervention of
antipsychotic drugs. There are certain helpful drugs which are tried to be induced to derive
desired impacts in the form of appropriate agents. The subsequent anxiety disorders along with
cognitive enhancers and adequately addressed through the drug-induced treatment measures
(Jackson et al. 2017). While the clinician is involved in the process of preparing the prescription,
the principal attributes are necessary to be taken into serious consideration. The anticonvulsant
and antipsychotic drugs are the relevant to course of treatments that are necessary to be directed

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towards the patients having such BPSD manifestations. While the focus is laid upon deriving
effective characteristics and treatment relevant to address the Behavioral and psychological
symptoms of dementia (BPSD), the other spoke are also necessary to be assessed. The treatment
etiological configuration of depression, anxiety, psychosis and sleep disturbances along with
agitation and aggression are necessary to be taken into the field of intervention.
Conclusion
It is found that Behavioral and psychological symptoms of dementia (BPSD) are a significant
disorder condition which takes relevant aspects into consideration. There are certain common
causes and effects that are likely to be put to the scope of present discussion (Randle et al. 2019).
It can, therefore, be understood that effective measures shall be applied so that effective
management protocols are implemented towards addressing the Behavioral and psychological
symptoms of dementia (BPSD). It is understood that patients having such symptomatic
representations are essentially under the clinical sphere of acknowledgment. It requires the
treatment course to be based upon definite platforms. There are specific etiological frameworks
prepared in context with such effective consequences. The person who is affected with such
symptoms at a later age of life is most likely to be co-morbidly impacted with certain other
complications as well. The physiological and mental complexities are likely to be understood so
that effective causative agents are tried to be identified. To address those specific areas of
difficulties and discrepancies, the necessary treatment course is likely to be illustrated. It is
therefore expected that the treatment measure shall be carried out by the professional clinicians
under specific test results (Taylor, Barnes & Young, 2018). The inventories that are administered
to the clients are understood to express different results with a score about different paradigms.
Each of these is likely to manifest about the treatment severity and needs. It is in relationship
with these aspects that the subsequent treatment orientation is planned towards patients having
Behavioral and psychological symptoms of dementia (BPSD). There are either pharmacological
or non-pharmacological intervention methods stipulated. It is planned that adhering to such an
effective paradigm each of the measures whether pharmacological or non-pharmacological shall
be taken into consideration in an effectual manner.

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