Language paradigms when behaviour changes with dementia: #BanBPSD

The term behavioural and psychological symptoms of dementia (BPSD) first arose following a meeting of the International Psychogeriatric Association (IPA) in 1996. The primary purposes of the meeting were to review current understandings of “behavioural disturbances” of dementia, as they were then described, and to reach consensus on four key areas, namely, definition of symptoms, causes of symptoms, definitions of clinical symptoms, and research directions. While behavioural symptoms associated with dementia have been documented since the condition was first recognised, it was not until the 1980s that a dedicated focus on the behavioural symptoms associated with dementia clearly emerged. A key motivation for the development of a new term in the 1990s was a desire to better understand the lived experience of people with dementia and their carers: why they behaved the way they did and what was the impact of their behaviour. It was also an attempt to counter criticism at the time of prevailing terminology such as challenging behaviours. Researchers and clinicians alike had been aware that BPSD are associated with premature admission to residential care, increased hospitalisation, distress for carers, and reduced functional ability for the person with dementia. It was hoped that a new focus on understanding behaviours would facilitate improvements in both care and quality of life for people with dementia and their carers. This is, at least in part, what has since occurred. Since the mid‐ 1990s, there have been numerous studies aimed at improving care for people with dementia. Initially, there was a tendency for research to focus on listing and categorising different types of BPSD and to review different treatments or responses against these categories. However, it is now accepted that people experience dementia in a personal way and that BPSD vary greatly among individuals according to a broad range of psychosocial factors, such as life history and culture. It is also acknowledged that any “intervention” for people with BPSD must be tailored to their individual needs and situation. While most “treatments” for behavioural and psychological disturbances have focussed on the use of psychotropic medications, there has been a growing interest in non‐pharmacological interventions for people living with dementia, beginning in the 1980s and expanding over subsequent decades. Today, guidelines authored by medical organisations and expert groups recommend psychosocial approaches