Advocacy, Antipsychotic drugs, NHBPS, Toward better care

20 compelling reasons to rethink the way we label and medicalise the behaviour of people who live with dementia #BanBPSD

In June this year, I posted an open letter to the worldwide dementia care community. Since then, advocates and activists such as myself, including Dr. Al PowerDaniela GreenwoodHoward GordonLiz LesterLeah BisianiSonya Barsness, Dr. Chris Alderman, Kate Swaffer, and others, have joined forces to create an awareness and action campaign calling for the ban of the damaging and stigmatizing artificial construct BPSD (the short form of “behavioural and psychological symptoms of dementia).

As part of the campaign, fellow human rights and dementia care advocate Kate Swaffer penned “Rethinking Dementia: Normal Human Responses,” an excellent post wherein she lists fourteen simple examples of why we should #BanBPSD. Here are five from Kate’s list of 14 [I’ve added bits here and there, which I have enclosed in square brackets]:

I would add these six to Kate’s list of 14:

15 ) Labeling, medicalising and punishing normal human responses to being told to sit or stay still for long periods of time is abuse. Most people (75 per cent) say they would start to feel restless if made to sit longer than half an hour.

16 ) Labeling, medicalising and punishing normal human human bodily functions is cruel and abusive.

17 ) Labeling, medicalising and punishing an individual’s lifelong normal behaviour is cruel and abusive.

18 ) Labeling, medicalising and punishing an individual’s normal human responses to inadequate care, harmful environmental conditions and being restrained is cruel, abusive and wrong.

19 ) Labeling, medicalising and punishing an individual’s normal human responses to cruel, abusive, harmful and wrongful treatment by physically restraining them is abuse.

20 ) Labeling, medicalising and punishing an invidivual’s normal human responses to cruel, abusive, harmful and wrongful treatment by chemically restraining them is abuse and should be made criminal.

I highly recommend reading the full text of Kate’s excellent piece here, and I invite to also read my article “the broken lens of BPSD: why we need to rethink the way we label the behaviour of people who live with alzheimer’s disease,” which was published in the Journal of the American Medical Directors Association.

#IAmChallengingBehaviour #BanBPSD #WeCanCareBetter

take off the blindfolds and #BanBPSD: an open letter to the worldwide dementia community

7 problems with BPSD

the broken lens of BPSD: why we need to rethink the way we label the behaviour of people who live with alzheimer’s disease

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Advocacy, Antipsychotic drugs, Toward better care

7 problems with BPSD

The term “behavioural and psychological symptoms of dementia” (BPSD) is a harmful artificial construct used to inappropriately describe reasonable responses to adverse conditions and circumstances (RRACC) when such responses are expressed by people living with dementia (PLWD).

Some of the damaging and stigmatizing labels and descriptors associated with BPSD are “wandering,” “exit-seeking behaviour,” “challenging behaviours,” “combative,” “aggressive,” etc.

The term BPSD was coined in the late 1990s by the International Psychogeriatric Association (IPA). Twenty years on, a growing number of dementia care advocates worldwide are calling for the BPSD construct to be rejected by the geriatric healthcare professionals and researcher and to be banned from dementia care language (#BanBPSD). Prominent among those calling for the paradigm shift are dementia care pioneers Kate Swaffer, former nurse and care partner, speaker, blogger, activist, and author of What the Hell Happened to My Brain?, and Dr. Allen Power, geriatrician, speaker, author, trainer, consultant.

Dr. Power, whose books Dementia Beyond Drugs and Dementia Beyond Disease, are essential reading for geriatric health professionals, care workers and care partners, summarizes the problems with BPSD like this:

1 ) Relegates people’s expressions to brain disease

2 ) Ignores relational, environmental, historical factors and causes

3 ) Pathologizes normal expressions

4 ) Uses flawed systems of categorization

5 ) Creates a slippery slope to drug use

6 ) Fails to explain how drug use has been successfully eliminated in many nursing homes

7 ) Misapplies psychiatric labels, such as psychosis, delusions and hallucinations

Essentially, the broken lens of BPSD stops us from seeing the real causes of the reasonable reactions to adverse conditions and circumstances (RRACC) when expressed by PLWD, and thus impedes dementia care practitioners and researchers from finding and employing effective, enabling and engaging solutions to the distress experienced by many PLWD.

#IAmChallengingBehaviour #BanBPSD #WeCanCareBetter

https://myalzheimersstory.com/2017/11/25/101-potential-causes-of-behaviours-by-people-living-with-dementia-that-institutional-care-staff-may-find-challenging/

https://myalzheimersstory.com/2017/11/15/the-broken-lens-of-bpsd-why-we-need-to-rethink-the-way-we-label-the-behaviour-of-people-who-live-with-alzheimers-disease/

 

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Advocacy, Antipsychotic drugs, Poetry

confused, not clueless

Some people answer questions with questions. This is a poem in answer to a poem penned by dementia care advocate, author, blogger, and South Australia’s Australian of the year 2017 Kate Swaffer. Her poem “OK, where are my glasses?” inspired me and the words for this one tumbled out willy-nilly. I hope you enjoy it.

confused, not clueless

© 2017 punkie

where have you gone
oh things I once knew
glasses, and jackets –
are you in the stew?

the phone looks just like
the TV remote
and my memory seems
to have gone up in smoke

who took my keys? and
the cat is now missing
“please let me find them,”
my mind keeps on wishing

i look in the bed
in the drawers, and the freezer
why do i suddenly
feel like an old geezer?

“stop repeating yourself,”
chide my son and his daughter
but the questions keep coming
like waves on the water

i still love to talk,
to walk, and to sing,
why do folks guess
i can’t do a thing?

a thing I can do
perhaps even two
so delete your believing
i don’t have a clue

i’m as smart as a whip
i always have been
if you show some respect
i won’t be so mean

don’t feed me chill pills
mashed up in my sup
treatment like that
makes me want to throw up

i crave more, i need better
stop thinking i’m dead
just because a few brain cells
have shrunk in my head!

 

© 2017 Susan Macaulay. I invite you to share my posts widely, but please do not reprint or reblog or copy and paste my poems and posts into other blogs or social media without my permission. Thank you.

https://myalzheimersstory.com/2017/06/20/the-demented-system/

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Advocacy, Life & Living

Kate Swaffer’s 8 wishes for dementia

46738394 - closeup of some unlit candles and just a lit candle after blowing out the cake

It’s not Kate Swaffer’s birthday, nor does she have a genie in a bottle, but she has wishes. Big ones.

“To keep suggesting there will ever be a world without dementia is truly insensitive, and in my humble opinion, rather pointless and stupid,” wrote dementia care advocate Kate Swaffer in her usual frank style.  “I really am sick of the fundraising campaigns using it too, as the money for research is not being shared enough with those who want to research better care.”

Swaffer, a former nurse and care partner to several family members who lived with dementia, has a Masters of Science (Dementia Care, Distinction, 2014); she herself lives with young onset dementia. Swaffer is one of the founders of Dementia Alliance International; she is also a prolific blogger, author, poet, as well as a wife and mother.

I agree with Swaffer’s take on the general attitude most people have toward dementia and research. While the goal of ending Alzheimer’s is admirable, we need to spend a whole lot more time, money and energy finding ways for the people who live with Alzheimer’s disease and other dementias to live well, and for those who are their care partners to be trained in the skills and knowledge required to provide the best care they can. If we don’t find ways to deal more effectively with caring for people who live with Alzheimer’s disease, our healthcare systems and our families will be decimated.

Here are Swaffer’s eight wishes for dementia (originally posted here), with relevant links back to posts on her blog all of which are well worth reading:

  1. Better care
  2. Less stigma
  3. Rehabilitation
  4. Less discrimination
  5. Less fear & more kindness
  6. Better access to our community 
  7. Disability support like everyone else gets
  8. Support to live with dementia, not just to die from it

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