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Behavioral consultation system for behavioral and psychological symptoms of dementia(BPSD) in elderly care settings: Case study on protocol feasibility using a flowchart

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  • 介護現場における認知症の行動・心理症状 (BPSD) に関する行動コンサルテーションの仕組み作り: フローチャート化した手順の適用可能性に関する事例的検討
  • カイゴゲンバ ニ オケル ニンチショウ ノ コウドウ ・ シンリ ショウジョウ(BPSD)ニ カンスル コウドウ コンサルテーション ノ シクミ ズクリ : フローチャートカ シタ テジュン ノ テキヨウ カノウセイ ニ カンスル ジレイテキ ケントウ

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Abstract

A behavioral consultation (BC) flowchart of BC protocols for behavioral and psychological symptoms of dementia (BPSD) in elderly care settings was developed by considering different patterns of the com-plete consultation. Then, we administered the BC to six BPSD cases using the protocol and examined its feasibility. The patterns of consultations included: (A) recommending referral to a more appropriate facili-ty such as a hospital, in the first general interview with the consultee, because an urgent problem was found; (B) conducting only an assessment in the baseline period; (C) developing an intervention plan from the functional assessment and assigning care workers to conduct the plan; (D) adjusting plans that do not fit the BPSD from the perspective of the integrity of staff members to the care plan, and assigning care workers to reconduct the plan. Feasibility of the protocol was examined based on the following points: (1) including or not including the BC patterns of the case in the protocol; (2) completing or not completing each consultee’s requests; and (3) the BPSD was improved or not improved. Results indicated that five of the six cases fitted the protocol patterns. However, one case did not match the protocol because the plan could not be adjusted at Stage D due to the need to reconsider the target behavior. Moreover, all the cases fulfilled the request of each consultee. BPSD decreased in cases where interventions were conducted. The above results confirmed the feasibility of the protocol except for one part of fitting to the protocol. It is suggested that a controlled trial with a large sample should be conducted in the future, after adding a new pattern to reconsider the target behavior.

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