Murphy Kayla S, Atkinson David M, Starks Jamie
Psychiatry, University of Minnesota, Minneapolis, USA.
Psychiatry, The University of Texas (UT) Southwestern Medical Center, Dallas, USA.
Cureus. 2023 Apr 10;15(4):e37387. doi: 10.7759/cureus.37387. eCollection 2023 Apr.
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.
痴呆的行为和心理症状(BPSD)很常见,且与痴呆患者发病率和死亡率的增加相关。在本报告中,我们描述了一名患有严重BPSD的患者,其通过多种非药物策略得到了有效管理。一名70岁的海军退伍军人,曾是商业地板业务的退休老板,有痴呆病史,因攻击性行为入院。他的家人已无法照料他。住院期间,他需要间歇性使用约束措施和多种抗精神病药物。他大部分时间都在地板上爬行,“摆弄”地砖,这常常让工作人员难以安全应对。然而,随着时间的推移,跨专业工作人员识别出了痛苦迹象,并制定了策略来安全地引导患者对自身状况的当前认知。该病例凸显了BPSD可能由一个人生命早期阶段的身份和角色所驱动。灵活地处理和管理这些症状可以改善痴呆护理。