DementiaRoadmap Wales

Promoting living well with dementia across Wales

Optimising treatment and care for behavioural and psychological symptoms of dementia

July 28 2011
Optimising care

This best practice guide has been developed in consultation with an advisory group of leading clinicians specialising in dementia.

It aims to provide evidence-based support, advice and resources to a wide range of health and social care professionals caring for people with dementia who have behavioural and psychological symptoms. It has been designed to be a practical, informative tool, with an emphasis on alternatives to drug treatment.


More than 90 per cent of people with dementia will experience behavioural and psychological symptoms of dementia (BPSD) as part of their illness and nearly two thirds of people with dementia living in care homes are experiencing these symptoms at anyone time.

BPSD cause distress to the individual, add considerably to the stresses experienced by family and professional carers and can result in serious risks to the person and others. Many individuals experiencing these symptoms do not have the legal capacity to make informed decisions about their treatment. Care should therefore be taken to use this guide within the context of the Mental Capacity Act.

Good practice recommendations, such as the NICE dementia guidelines, recommend psychosocial interventions as the first line approach and emphasise the importance of assessing medical conditions and pain, which often underpin the development of these symptoms.

The value of not rushing into treatment is also important, as many people with BPSD will experience significant improvement or resolution of symptoms over a 4–6 week period.

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