Old Age Psychiatrist, Conjoint Professor UNSW; Clinical Associate Professor Sydney University; President of Capacity Australia; Co-author of the E-text “Capacity and the Law; Chair of the IPA Taskforce on Capacity; Former Professional Member Guardianship Tribunal NSW (now NCAT).
Changed behaviours, formerly known as BPSD, are almost ubiquitous in dementia, with prevalence rates up to 97%, although given that they are usually an expression of unmet need, the quality of care probably determines their prevalence. The recent Royal Commission into Aged Care Quality & Safety has shown us what we have known for almost 30 years, namely that there is widespread and inappropriate use of psychotropics. Notwithstanding this, the 2003 Brodaty triangle illustrating a 7-tiered model of service delivery showed a small but significant number of people with dementia who have severe or refractory changed behaviours. Moreover, the serious side effects of currently available psychotropics have necessitated a search for creative alternative solutions, such as cannabinoids. This presentation will briefly review these issues and explore the evidence for these creative solutions.
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