Many relevant aspects of health present through behavior, affect, and interaction. They require observation rather than instrumental measurement. This is particularly relevant when assessing behavioral symptoms of dementia because symptoms can fluctuate over time. Little is known about how structured daily symptom assessments can fit into routine dementia care. That is, until now!

In a study published in JMIR Aging, researchers found that daily observations can and should be integrated into dementia care. That said, researchers identified time constraints as a stick in the spokes. They also noted inconsistent participation and varying levels of confidence when interpreting behaviors. Documentation adherence also varied depending on the time of day.

Back in the day when I was working on a Medicare unit, documenting behaviors was a mandatory piece of our daily documentation. Before administering any psychoactive medication, we documented the behaviors the resident exhibited. We also documented how we intervened non-pharmacologically. We kept the documentation on the back side of the MAR, which was paper at the time. Nurse management audited these forms daily. Long ago and far away, but still relevant according to the research!

What is your system for documenting resident behaviors and interventions? Are you medicating residents when you may have an opportunity to address the behavior without medication? Understanding and documenting behavioral symptoms of dementia may help staff identify patterns, triggers and interventions that have worked in the past.

Look at your quality-of-life program. Assess each resident as an individual and determine whether you can identify triggers. Talk to the family. They know the resident way better than you ever will. Train your staff. This is key. If a resident exhibits a particular behavior, what worked in the past to change that behavior?

All these things sound easy, but they are not. However, if you focus on quality of life, it is worth the effort. Resources from PsychDB provide additional information about behavioral and psychological symptoms of dementia. You can also review this BPSD clinical guideline from Oxford Health and additional research on the management of behavioral and psychological symptoms of dementia for assistance and guidance in enhancing your behavior management program.

Stay well and stay informed!