Ward based management of behavioural and psychological symptoms of dementia

### What you need to know An 81 year old woman with vascular dementia has been admitted to the hospital following a fall in the community and is currently an inpatient on the ward. You are the doctor on call and have been asked to review the patient as she appears more confused and is trying to leave the ward. Worldwide, dementia affects 50 million people, with a predicted increase to 82 million by 2030.1 Dementia is characteristically progressive and severely affects activities of daily living. Behavioural and psychological symptoms of dementia (BPSD) refer to a cluster of symptoms of dementia relating to perception, mood, thought content, or behaviour.2 They are associated with increased care costs and are important prognosticators of admission to nursing homes. It is estimated that more than 80% of people with dementia will experience BPSD during the course of the disease.3 BPSD are challenging to manage for patients, carers, and healthcare workers, but effective management can substantially improve quality of life for both patients and carers. As people with dementia make up a relatively high proportion of hospital inpatients, clinicians working in an acute setting are likely to encounter BPSD often. This article aims to introduce clinicians to BPSD, their key triggers in an inpatient …