The Importance of Person-Centered Approaches to Managing Behavioral and Psychological Symptoms of Dementia: A Case Report

• Published in: Curēus (Palo Alto, CA) Vol. 15; no. 4; p. e37387
• Main Authors: Murphy, Kayla S, Atkinson, David M, Starks, Jamie
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 10-04-2023; Cureus
• Subjects: Activities of daily living; Aggressiveness; Alzheimer's disease; Antipsychotics; Apathy; Behavior; Caregivers; Case reports; Cognitive ability; Dementia; Flooring; Mortality; Neurology; Palliative Care; Patient-centered care; Physical restraints; Psychiatry; Psychosis; Psychotropic drugs; Quality of life; Therapy; long term care; supportive and palliative care; cognitive impairment and dementia; behavioural and psychological symptoms of dementia (bpsd); veterans health
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.37387

Behavioral and psychological symptoms of dementia (BPSD) are common and associated with increased morbidity and mortality in dementia. In this report, we describe a patient with severe BPSD who was effectively managed with a variety of non-pharmacologic strategies. A 70-year-old Navy veteran and retired commercial flooring business owner with a history of dementia was admitted to the hospital with aggressive behavior. He was no longer manageable by his family. He required intermittent use of restraints and multiple antipsychotics during hospitalization. He spent much of his time crawling on the floor, "working" on floor tiles, which was often difficult for staff to safely accommodate. However, with time, interprofessional staff identified signs of distress and developed strategies to safely engage the patient's current perception of his situation. This case highlights how BPSD may be driven by a person's identities and roles from earlier stages of life. Approaching and managing these symptoms flexibly can enhance dementia care.