[Recommendations for the diagnostic and therapy of behavioural and psychological symptoms of dementia (BPSD)].

INTRODUCTION: The «Recommendations for the Diagnosis and Treatment of Behavioral and Psychological Symptoms of Dementia (BPSD)¼ were developed in parallel with the Swiss National Dementia Strategy 2014-2019 under the auspices of the Swiss Society for Geriatric Psychiatry and Psychotherapy (SGAP) and mark the beginning of a series of recommendations for geriatric psychiatric disorders. They depict the evidence-based state of knowledge about diagnostics and therapy, based on the clinical experience of the experts, and are designed for interprofessional and interdisciplinary use. The non-pharmacological intervention options and pharmacotherapy are discussed in detail. This paper is the revised version of the 2014 publication and compiles the development in this area for everyday clinical practice.

Nurses' experiences of an outreach interprofessional mental health service for nursing homes: a qualitative descriptive study.

WHAT IS KNOWN ON THE SUBJECT?: Treatment and mental health care in familiar environments are beneficial for older people experiencing mental health issues. But there are not enough qualified and specialized nurses who can meet the complex needs of nursing home residents experiencing mental health issues. The University Hospital of Psychiatry Zurich, Switzerland, established an outreach interprofessional mental health service to foster the care for residents experiencing mental health issues in nursing homes. Based on existing studies, little can be said about whether nurses in nursing homes find these types of services helpful. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Nurses in nursing homes caring for residents experiencing mental health issues felt relieved by having inclusive support from the interprofessional mental health service. Nurses appreciated the mental health team and felt accompanied and more confident in their daily work. Results showed that nurses wanted to be included in the care and treatment processes and to work as partners on an equal footing with the mental health team. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Outreach interprofessional mental health services for nursing homes should take into account nurses' views and professional experience, and value and respect their role as nurses. Outreach interprofessional mental health services for nursing homes should offer further training in psychiatric nursing, include an accessible contact person in the team, and develop clear processes and responsibilities. ABSTRACT: INTRODUCTION: Outreach interprofessional mental health services for nursing homes can increase the quality of care for residents experiencing mental health issues but research on how nurses in nursing homes experience such a service is lacking worldwide. AIM: To describe how nurses experience the involvement of an outreach interprofessional mental health team in the care for older people experiencing mental health issues in nursing homes and to identify barriers to and facilitators of interprofessional collaboration. METHOD: Qualitative descriptive analysis based on 13 semi-structured interviews. Framework analysis and complex adaptive systems theory were applied. RESULTS: One core theme with two main categories: Nurses experienced relief from burden through inclusive support provided by the mental health team. Main categories were feeling accompanied and confident as a nurse and partnership-based collaboration. DISCUSSION: Results showed for the first time that nurses felt supported by the mental health team and were encouraged to find new ways of coping with challenging situations. IMPLICATIONS FOR PRACTICE: To empower nurses, mental health teams should take into account nurses' perceptions in the treatment process, value and respect their role as nurses, transfer knowledge in both formal and informal settings, establish a steady and reliable contact person, and define processes and responsibilities.

[Recommendations for the Diagnosis and Therapy of Psychotic Disorders in the Elderly]. / Empfehlungen für die Diagnostik und Therapie psychotischer Erkrankungen im Alter.

Recommendations for the Diagnosis and Therapy of Psychotic Disorders in the Elderly Abstract. Psychotic disorders in the elderly cover a wide range of causes and manifestations. They often occur as part of a depression, dementia, substance abuse or delirium. While psychosis can occur with a first manifestation in advanced age, many patients with chronic psychotic disorders reach a high age. Many elderly individuals are also affected by cognitive impairment and somatic conditions, making a third-party history most relevant. The associated changes in life and the complexity of the individual situation needs to be integrated into the diagnosis and treatment. The presented recommendations have been developed under the lead of the Swiss Society of Old Age Psychiatry (SGAP) in collaboration with the Swiss Association of Nurses (SBK) and the subcommittees for gerontological and psychiatric nursing of the association of nursing science (VFP) as well as further professional societies. We aim to make current knowledge concerning diagnosis and treatment available to the interprofessional teams working in in- and outpatients' settings.

[Recognition of Psychiatric Symptoms in Inpatient Long-Term Care]. / Erkennung psychiatrischer Symptome in der stationären Langzeitpflege.

Recognition of Psychiatric Symptoms in Inpatient Long-Term Care Abstract. As part of the Swiss national strategy on dementia, we investigated to which extent the needs assessment instruments RAI and BESA can early detect symptoms of depression, delirium, and behavioral and psychological symptoms of dementia (BPSD) in long-term care facilities. While we decided that the RAI sufficiently detected depressive symptoms, we suggest to add the two-questions-test and the geriatric depression scale to the BESA assessment. The BESA evaluation had more targeted focused assessments, allowing for better identification of delirium. Neither RAI or BESA cover the whole spectrum of behavioral and psychological symptoms of dementia. We consider the continuous application of these assessment instruments an important step towards interdisciplinary exchange and a better treatment of residents with psychiatric symptoms.

[Family members' experiences of caring for persons with dementia and outreach counseling--an interpretative phenomenological study]. / Erfahrungen Angehöriger mit der Betreuung von Menschen mit Demenz und zugehender Beratung. Eine interpretierende phänomenologische Studie.

BACKGROUND: Almost two-thirds of the 110,000 people living with dementia in Switzerland receive home care from family members. Outreach counselling can reduce the burden for family caregivers and delay nursing home placement. However, little is known of how this works and how caregivers experience the counselling. The Canton of Aargau Alzheimer's Association has been conducting a pilot project to demonstrate the necessity, effectiveness and practicability of outreach counselling in (their canton). AIM: As a part of the evaluation of the project this study explored how family members experience the process of caring for a relative with dementia and outreach counselling. METHOD: Interpretive phenomenology­a qualitative approach­was used to analyse data from interviews with twelve family caregivers. RESULTS: Most family members felt supported in caregiving by outreach counselling. Three aspects of the counselling were especially important to the participants: being understood and taken seriously by the counsellor; receiving answers to their most pressing questions concerning the illness and being supported when difficult decision had to be taken; regaining personal time and learning how to better interact with the person with dementia. Two participants would have wished for more help by the counsellor. CONCLUSIONS: To meet the needs of the family members, consultants should have sufficient experience in dementia patient care and should be strongly networked across the local health and welfare system. This study shows that family members can experience outreach counselling as a great support in their caregiving roles.