HEIDI DOUGLASS | h.douglass@unsw.edu.au

Research undertaken by The Dementia Centre, HammondCare, has retrospectively reviewed the effectiveness of Special Dementia Care Programmes, for people with very severe behavioural and psychological symptoms of dementia. 

Behavioural and psychological symptoms of dementia (BPSD) – which include hallucinations, anxiety, agitation, aggression, apathy and depression – occur in up to 90% of people living with dementia. These symptoms occur with greater frequency as the disease progresses. 

It is estimated that less than 10% of Australians living with dementia will demonstrate aggressive behaviours that are deemed unmanageable in mainstream care, and only 1% will manifest very severe symptoms, indicating the necessity for specialist programmes to stabilise and reduce symptoms over time to enable transition back to a less intensive care setting.

The 10-year retrospective review, published in the Australasian Journal on Ageing, describes environmental design, governance, clinical processes, characteristics and outcomes for 80 residents within similar Special Dementia Care Programmes – with a key finding that the average stay was just over 12 months.

Dr Meredith Gresham as the then Head of Research at The Dementia Centre, HammondCare in 2020 led this research. Dr Gresham, now a Research Fellow with the Centre for Healthy Brain Ageing (CHeBA), said that people with severe BPSD are more likely to receive inappropriate or prolonged use of medication, poor quality of life and tenuous accommodation and more frequent transfer to acute care; factors which prompted the Australian Government to establish the programmes.

“These programmes were designed to provide interim care for up to 12 months for those unsuitable for mainstream aged care,” said Dr Gresham.

"They are important as they lead to significant reduction in antipsychotic and anxiolytic medications and transfer to mainstream aged care services.

Dr Meredith Gresham

'Linden’, a successful Special Dementia Care Programme led by HammondCare, has been operational for over ten years providing specialist accommodation and behavioural management for older people.

“Linden is a clear example of how this model can support a majority of residents with very severe BPSD to be transferred to mainstream aged care after approximately 12 months,” said Dr Gresham.

Co-Director of CHeBA, Professor Henry Brodaty, said Special Dementia Care Programmes were critical as they have the potential to improve care and outcomes for this group of older people. 

"Future research should focus on confirmation of the impact of the Special Dementia Care Programme model and management strategies on resident behaviour as well as training and education to improve integrated care and service provision for this vulnerable group of people."

Professor Henry Brodaty