Behaviour Support Programs
The Dementia Behaviour Management Advisory Service (DBMAS), Severe Behaviour Response Teams (SBRT) and the Specialist Dementia Care Program (SDCP) form part of a three-tiered approach to behaviour support for people experiencing behaviours and psychological symptoms of dementia (BPSD). Each tier provides support for symptoms of increasing severity: DBMAS for mild to moderate symptoms; SBRT for more severe BPSD; and the SDCP transitional residential care for those with very severe BPSD.
Dementia Behaviour Management Advisory Service (DBMAS), delivered by Dementia Support Australia, is a mobile workforce of health and allied health professionals who provide support for people living with dementia and their carers, whose wellbeing or care is impacted by the presence of mild to moderate behaviours and psychological symptoms of dementia. DBMAS supports people with dementia and their carers living in community, residential care, and acute care settings.
Severe Behaviour Response Teams (SBRT), also delivered by Dementia Support Australia, provide support for people living with dementia and their carers, whose wellbeing or care is impacted by the presence of severe behaviours and psychological symptoms of dementia. SBRT supports people with dementia and their carers residing in Commonwealth-funded residential aged care facilities, multi-purpose services, or flexibly funded services.
Specialist Dementia Care Program (SDCP) provides a person-centred, multidisciplinary approach to care for people experiencing very severe BPSD, whose behaviours may put them or others at risk, or otherwise mean they are unable to be appropriately cared for by mainstream aged care services. The SDCP offers specialised, transitional residential support in a small dementia friendly unit, focusing on reducing or stabilising symptoms over time, with the aim of enabling people to move to less intensive care settings.
Between January to June 2018 and January to June 2022 there was a 123% increase in the total number of referrals that were supported by DSA – a 115% increase for the DBMAS and 196% increase for SBRTs. This increase is likely due to increased awareness of DSA, combined with a growing importance of supporting people experiencing behaviours and psychological symptoms of dementia in Australia. Inadequate care for this group was highlighted in the Royal Commission into Aged Care, Quality and Safety.
Select a 6-month time period (between 1 January to 30 June 2018 and 1 January to 30 June 2022) in Figure 10.1 to explore the profile of DSA referrals during this time.
Figure 11.1: Profile of referrals to Dementia Support Australia (DSA)
Figure 11.1 is a panel of figures including bar graphs and pie charts showing demographic characteristics and service use information of referrals to Dementia Support Australia in 6 month periods between January to June 2018, and January to June 2022. For each 6 month period, women accounted for a slightly greater percentage of referrals than men. The majority of referrals were for people living in residential aged care, and those living in Major cities from the most populous states (New South Wales, Victoria and Queensland). The majority of referrals were for accessing the Dementia Behaviour Management Advisory Service rather than Severe Behaviour Response Teams. The most common type of dementia recorded was Alzheimer’s disease, closely followed by Unspecified dementia.
Between January and June 2022, there were 8,702 referrals to DSA. This had slightly decreased by 4.4% (from 9,106 referrals) from the number of referrals in the previous 6 months (July to December 2021).
From January 2020 onwards, DSA were able to continue to deliver services when there were changes in public health policy as a result of the COVID-19 pandemic. This was achieved by adhering to social distancing and infection control requirements, as well as providing video conferencing services. DSA also released a resource for aged care services with tips for managing a person living with dementia whose behaviour may be impacting their care.
Specialist Dementia Care Program
The Specialist Dementia Care Program (SDCP) is an Australian Government initiative committed to establishing specialist dementia care units in dedicated facilities across Australia – providing individualised care to people who are experiencing severe behaviours and psychological symptoms of dementia and who can no longer be managed by their carers or by mainstream residential aged care services. The benefit of specialised dementia care units is that the person experiencing severe behaviours and psychological symptoms of dementia can receive personalised, specialist care in an environment uniquely designed for a person with dementia.
DSA assesses eligibility for the SDCP through their Needs Based Assessment program.
Once approved, a person will enter the program within 3 months, or undergo reassessment, and their length of stay in a SDCP unit will vary (usually up to 12 months). When specialist care is no longer required, providers must support the person’s move into a less-intensive care setting.
The first prototype of the specialist dementia care unit under the SDCP began operating in Perth, Western Australia in 2019. Approved residential aged care providers can apply for program grants to set up units in their facility, and there have been a number of specialist dementia care units funded for operation to date. Work is currently underway to improve understanding of the need for these units across Australia.