Hazzard's Geriatric Medicine and Gerontology, 8e >Behavioral Symptoms of Dementia and Psychoactive

Drug Therapy
Jeffrey B. Halter, Joseph G. Ouslander, Stephanie Studenski, Kevin P. High, Sanjay Asthana, Mark A. Supiano, Christine S. Ritchie, Kenneth Schmader+
TABLE 60-4DESCRIBE, INVESTIGATE, CREATE, AND EVALUATE (DICE) APPROACH

Caregiver describes problematic behavior

Context of behavior

Describe Social and physical environment

Patient perspective

Degree of distress to patient and caregiver

Provider investigates possible causes of problem behavior

Undiagnosed medical conditions

Underlying psychiatric comorbidity

Limitations in functional ability

Poor sleep hygiene

Investigate
Boredom, fear, sense of loss of control

Medication side effects

Sensory impairment

Environmental factors

Unmet needs

Provider, caregiver, and team collaborate to create and implement treatment plan

Respond to medical problems

Strategize behavioral interventions

Provide caregiver education and support

Create Create meaningful activities for the patient

Simplifying tasks

Ensuring the environment is safe

Enhancing communication with the patient

Increasing or decreasing stimulation in the environment

Provider evaluates whether the interventions have been implemented by caregiver and whether they
Evaluate
are effective

Data from Kales HC, Gitlin LN, Lyketsos CG, et al. Management of neuropsychiatric symptoms of dementia in clinical settings: recommendations from a multidisciplinary expert panel. J Am Geriatr Soc.
2014;62(4):762–769.
Date of download: 12/29/22 from AccessMedicine: accessmedicine.mhmedical.com, Copyright © McGraw Hill. All rights reserved.