Managing Behavioral and Psychological Symptoms of Dementia and/or Delirium Superimposed on Dementia in Long-Term Care Hospitals: Nurses' Practical Perspectives

Purpose: The current study examined RNs' practical experiences in managing behavioral and psychological symptoms of dementia (BPSD) and delirium superimposed on dementia (DSD) in long-term care hospitals. Method: In-depth, one-on-one interviews were conducted with 18 RNs—including charge nurses, head nurses, and general staff—at two long-term care hospitals. Results: Nurses reported significant challenges in distinguishing and managing BPSD and/or DSD due to limited symptom-specific knowledge, overlapping clinical presentations in older adults, and resource constraints. Despite these barriers, they actively applied practical strategies to interpret symptoms and initiate appropriate interventions. Conclusion: Findings highlight the need for targeted education and structured clinical support to strengthen nurses' capacity to differentiate and manage BPSD and DSD. Enhancing institutional systems and interdisciplinary collaboration is essential to improving dementia care in long-term care hospitals.