I’ve written many time about BPSD or ‘challenging behaviours’ as well as what I have termed BPSC-19, but the comparison may not be obvious to everyone. Hence, for day 27 of Dementia Awareness Month in 2020, I decided to list the ‘symptons’ of each here.
If we check out the two lists we could be forgiven for thinking BPSD is wrong, and doesn’t really exist, or, people with BPSC will soon be held to a higher account as well, for similar normal human responses to the challenging restrictions enforced by the pandemic, such as enforced isolation, the resulting loneliness, and the physical and social distancing.
Behavioural & Psychological Symptoms of COVID-19 (BPSC-19)
People are continuing to self report or are seen to be experiencing Behavioural and Psychological Symptoms of COVID-19 (normal human responses to the pandemic), including:
- mood disturbance, e.g. depression
- stress due to enforced isolation and distancing
- reactions due to the amygdala (fight or flight)
- anger (fight response)
- aggression (fight response)
- irritability (mood disturbance)
- trying to escape (flight response, wandering)
- Hoarding (excessive shopping)
- absconding (flight response, wandering)
- being irrational (e.g. fighting for toilet paper or spitting on fruit in the supermarket)
- difficulty making decisions (should I visit my son before they close the borders)
- excessive worrying
- inability to concentrate, or do simple tasks such as spell
- poor sleep (sleep disturbance)
- awaking the middle of the night (nocturnal disruption)
- sundowning (nocturnal disruption)
Behavioural & Psychological Symptoms of Dementia (BPSD)
This is what the Behaviour Management: A Guide to Good Practice (BPSD Guide) Guidelines published in 2012 say:
- Behavioural and psychological symptoms of dementia (BPSD) are defined as “symptoms of disturbed perception, thought content, mood, behaviour frequently occurring in patients with dementia”.
- They are also commonly referred to as behaviours of concern, challenging behaviours and non-cognitive or neuropsychiatric symptoms of dementia.
- BPSD include aggression, apathy, anxiety, agitation, psychotic symptoms, depression, disinhibited behaviours, wandering, nocturnal disruption and vocally disruptive behaviours.
In their Table of Contents, noted as modules, the following are listed ‘symptoms’ of BPSD:
- Disinhibited behaviours
- Nocturnal disruption
- Psychotic symptoms
- Vocally disruptive behaviours
Note: Other BPSD guides would include other ‘symptoms’ in this list, such as hallucinations.