There is often talk of „challenging behavior“ in people with dementia and of so-called behavioral and psychological symptoms. We explain what these terms mean.
BPSD is the abbreviation for „Behavioural and Psychological Symptoms.“ The English technical term has long been established in the professional world. In German, it refers to the so-called behavioral and psychological symptoms that can occur in people with dementia, such as hallucinations, euphoria, irritability, apathy, depression, and anxiety. Depending on the course of the disease and the severity of dementia, these symptoms vary in intensity; some occur simultaneously, and they range from mild to very severe. The transitions are fluid.
Behavioral and psychological symptoms often pose a significant challenge for people with dementia as well as their caregivers and family members, demanding all their efforts.
When the last straw breaks
The demands are then diverse and can lead to severe psychological stress and impairment. For example, because communication with those affected is no longer successful. Because patience runs out when people with dementia react differently than usual. Because those affected behave – from the perspective of caregivers – in a „challenging“ way. This is not done intentionally. Relatives and caregivers should always be aware of this.
Term with many meanings
The term „challenging behavior“ has become established in professional dementia care, according to some experts. It encompasses the diverse reactions of people with dementia to their various feelings, states of well-being, and needs, some of which can no longer be expressed.
At digiDEM Bayern, we are moving away from the term „challenging.“ In our view, the term unfairly attributes a certain degree of personal responsibility to people with dementia regarding their behavior related to the illness. Instead, the umbrella term „behavioral and psychological symptoms“ should be used in our language to reflect what's necessary: to show respect for people with dementia, to preserve their human dignity, and to avoid stigmatizing them.
The revised S3 guideline „Dementia,“ which will be published in November 2023, takes this development into account and has adopted this terminology.
People with dementia need support from everyone. Nevertheless, the physical and psychological health of those who often go beyond their limits should also be considered: the caregivers and relatives.
You can find more information here:
Dementia Communication Guide from the German Alzheimer's Association
Dementia – Improving the living conditions of affected individuals
