MEDizzy - A 70-year-old male with moderate dementia (MMSE 16/30) was

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Geriatric Medicine 2

A 70-year-old male with moderate dementia (MMSE 16/30) was disruptive in the care home where he lived. What is the most appropriate management strategy to try to reduce his disruptive behaviour?

ExplanationIt is likely that he is bored and so diversion therapy, engaging him in some stimulating activity that he is interested in is an appropriate strategy. Simply ignoring the behaviour will not make it go away. Antipsychotic medications are over prescribed in care home residents and should only be prescribed for behavioural and psychological symptoms of dementia if the person is a danger to themselves or others. Rewarding good behaviour is unlikely to work and is potentially punitive and denies his human rights. Reminiscence therapy may be a suitable distracter, but is a second best option.