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New Treatment Techniques for Geriatric Psychiatry: Addressing Persistent Difficult Behavior in Patients with Dementia

New treatment techniques for geriatric psychiatry UPC KU Leuven

Press release | October 24, 2023

Persistent difficult behavior: it often causes a lot of distress in patients with dementia and their loved ones, even more so than the characteristic memory problems. But that aspect can be treated well. This is evident in the specialized Cog K department of the University Psychiatric Center KU Leuven.

Next Thursday, October 26, 2023, experts from home and abroad will discuss the origins and approach to anger and aggression in later life during the 8th Congress on Geriatric Psychiatry in Leuven.

When you say dementia, you immediately think of the progressive loss of memory that is so characteristic of the disease. Less well known but equally characteristic are the behavioral problems associated with the disease: such as persistent restlessness during the day, nighttime restlessness, verbal aggression, physical violence or sexual disinhibition.

These behavioral problems – doctors call them the neuropsychiatric symptoms of dementia – appear to be more disruptive than memory loss. For people who care for or live with someone with dementia, they significantly increase the burden they have to bear. The behavioral problems also accelerate the disease process and lead more quickly to admission to the residential care center.

Untenable at home

“Even though we cannot yet cure dementia as a disease, we can usually treat behavioral problems well,” says Professor Maarten Van Den Bossche. The geriatric psychiatrist works at Cog K, a specialized department within the UPC KU Leuven (Campus Kortenberg) for people who suffer from a cognitive disorder that is accompanied by serious behavioral problems.

“These are people who have been diagnosed with dementia and it is no longer tenable for their loved ones at home or the caregivers in the residential care center to care for them due to the persistent serious behavioral difficulties they face.

Better quality of life

With a stay of several weeks to months, they achieve very good results in the Cog K department. In the vast majority of patients, the behavioral symptoms decrease significantly within 8 weeks and the quality of life increases to such an extent that the patient can return home or to the residential care center.

“We owe these results to the targeted and intensive working method that we can use in this specialized department,” says Maarten Van Den Bossche. “The patients know they are surrounded by a warm, multidisciplinary care team that works according to the most recent scientific insights.” This involves therapists from various disciplines, a psychiatrist, a geriatrician and psychiatric nurses.

Sufficient staff and space

Head nurse Pieter Hoornaert adds. “The advantage in our department is that we can immediately start working with different employees when a new patient registers. The staffing is designed for this. And we also have sufficient space, with, for example, a large living space or separate corners or rooms where we can offer someone a quiet, low-stimulus place.”

Wide range of therapies

A second advantage is that the therapists and nurses in the department have a wide range of possible interventions or therapies available, in addition to the doctors who fine-tune the medical and medicinal treatment plan. They observe the patient and try out some strategies. A simple example is getting started with music with someone who loves music, and giving it a place in his or her daily structure.

“As a team member you can pass on your findings directly to your colleagues in the frequent briefings we hold. We would build a proposal with interventions and an appropriate daily schedule for the patient. We do this according to the DICE methodology: describe, investigate, create, evaluate. We go through those four steps in a circular manner over and over again. Every team member is trained for this.”

Consultation culture

“That method, with a strong consultation culture in the team and many opportunities for creative ideas, works wonderfully. With the input of the entire team, we quickly arrive at a new, good daily structure with adapted activities for the patient, with which he can return to the residential care center or home. We provide this plan upon discharge, and we invest a lot of time in briefing and consultation during the transfer to the care partners in the patient’s living situation.”

Job satisfaction

The freedom and opportunities for creativity are important reasons for employees to enjoy working here. They are also given sufficient time for additional training. And they find the fact that they can also consult patients’ families in a thorough manner – no quick conversations – very valuable. These are all factors for high job satisfaction, which reflects on the results we achieve for patients and their loved ones.”

Sensors to monitor agitation

Finally, head nurse Pieter also mentions the technical equipment in the department, another plus point for Cog K. “We have three types of rooms with different security levels. From standard, to increased surveillance with cameras, to what we call a room for high intensive care, with high security to minimize the risk of the patient being hurt.”

“A lot of scientific research is also done in our department,” adds Maarten Van Den Bossche. “We use sensors to look for new ways to monitor agitation and detect its causes, and test new interventions.”

“In short,” concludes Pieter Hoornaert, “the work of our therapists and nurses is very challenging. It requires a lot of knowledge of the diseases, but also practical skills, tact and creativity. But they are given the time to learn about the person behind the patient. They get a lot of satisfaction from that, as well as from the great results that follow.”

Contacts for the press

Prof. Dr. Mathieu Vandenbulcke, head of geriatric psychiatry UPC KU Leuven
Prof. Dr. Maarten Van Den Bossche, geriatric psychiatrist UPC KU Leuven

Interview appointments

+32 16 34 80 05

+32 478 35 51 16

patricia.vanherle [at] upckuleuven.be (subject: Press question%20-%20Behavioral problems%20with%20dementia%20good%20to%20treat)

From bad to worse,
about aggression in the elderly

8th Congress Geriatric Psychiatry UPC KU Leuven

Thursday October 26, 2023
Provincial House of Flemish Brabant in Leuven

Press is very welcome, by appointment.

Interview appointments

+32 16 34 80 05

+32 478 35 51 16

patricia.vanherle [at] upckuleuven.be (subject: Press question%20-%20Behavioral problems%20with%20dementia%20good%20to%20treat)

Conference topics

New developments in agitation and aggression in dementia: from prevention to intensive care | Prof. Maarten Van Den Bossche, geriatric psychiatrist UPC KU Leuven
Aggression in older people with personality disorders – from heterotypic continuity to elderly crime | Prof. Dr. Bas van Alphenprofessor of elderly psychology, Mondriaan Heerlen-Maastricht & VUB
Older perpetrators of crimes: many shades of gray | Stefaan De Smet, PhD, lecturer and scientific employee, Ghent University of Applied Sciences
Dealing with aggression within the UPC KU Leuven: an intensive (collaboration) collaboration from prevention to aftercare | multidisciplinary care team UPC KU Leuven
Multimodal imaging and neuromodulation in depression in the elderly: results from the Leuven Late-Life depression study | Study ed Prof. Dr. Jan Van den Stockneuropsychologist, KU Leuven
Resting-state functional brain changes in late-life depression | Chih-Hao Linkpsychologist KU Leuven
Synaptic plasticity: a search for the mechanism behind electroconvulsive therapy | Maarten Laroypsychologist KU Leuven
Psychomotor dysfunction in late life depression: an affective, cognitive or motor phenomenon? | Dr. Margot Van Cauwenbergeneurologist KU Leuven
Multidisciplinary intensive care for persons with dementia and serious psychiatric and behavioral problems | multidisciplinary care team UPC KU Leuven
Self-harm in the elderly | Lisa Van Hove, PhD student VUB
Fights in marriage: about violence in partner relationships later in life | Lies Van Assche, PhD and Luc Van de Ven, elderly psychologists UPC KU Leuven

Read the full conference programme

2023-10-23 16:34:59
#Behavioral #problems #dementia #properly #treated

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