In Australia, the number of cases of dementia is expected to increase from 245,400 in 2009 to 1.13 million cases by 2050. This is partly due to more people living longer and partly due to lack of effective preventative strategies.
The prevalence of dementia within the population is estimated at 5% in persons greater than 65 years old, 20% in persons greater than 80 years and 30% of persons greater than 90 years old. There is also evidence to suggest that mental disorder predisposes to dementia. It is therefore important that dementia is detected and treated early by a specialist.
What is a dementia psychiatrist?
A dementia psychiatrist is called an old age psychiatrist or a psycho-geriatrician. They are experts in diagnosing and treating old age mental health conditions. One of the common conditions they deal with is dementia. Common forms of dementia such as Alzheimer’s and vascular dementia are less complex and usually require only a dementia psychiatrist and your family doctor. Some forms of dementia such as Lewy body dementia or Parkinson’s dementia may require involvement of other specialists such as a geriatrician, a neurologist or a neuro-psychiatrist.
What are behavioural and psychological symptoms of dementia (BPSD)?
The management of dementia is complicated by behavioural and psychological symptoms of dementia (BPSD), such as psychosis, depression, agitation, aggression and disinhibition.
Rates of BPSD based on setting:
- 61% – 88% among people with dementia in a community setting
- 29% – 90% in residents of Australian nursing homes.
- 95% among hospitalised patients in long-term acute care.
BPSD in people with dementia is one of the most important modifiable clinical factors that determines some of the outcomes such as:
- Carer stress and carer burn out
- Reduced quality of life for the individual
- Breakdown of community care
- Increased rate of institutionalisation.
- Increased utilisation of health and welfare resources.
How can a dementia psychiatrist assist you?
A dementia psychiatrist has expertise and experience in accurately diagnosing and treating BPSD. This may involve a detailed assessment of the problem behaviours and linking it with the Bio-psycho-social framework. For instance, Agitation may be the symptom for which there could be numerous underlying factors such as pain, infection, and lack of sleep, anxiety, psychosis or mania. It may also be due to conflict with staff or co-residents. Hence understanding the factors is the first step before managing it. Authorities have strictly regulated the Pharmacological intervention (treatment using psychiatric medications for BPSD) in BPSD. A psychiatrist for dementia would help you balance the risks and benefits of using psychiatric medications in Dementia thus improving outcomes for the individual and everyone else involved in their care.
A psychiatrist for dementia could also help you navigate the fragmented aged care system which involves multiple agencies and stakeholders. Furthermore, a psycho-geriatrician may assist you with advocacy for the older person in a setting. They might also liaise with the aged care facilities or with private hospitals if they need respite care or hospitalisation.
Dementia psychiatrist Melbourne Dr Brij Kishore is offering his services at Mindoc clinic in Glen Waverley. Please feel free to give us a call or reserve your appointment with him by booking online.