Explaining dementia diagnosis, BPSD plan, and antipsychotic caution to family — CASC communication station

Open. Introduce role, acknowledge fear and anger: “You are right to question medicines and placement — those are big decisions.” [1]

Explain diagnosis. “The team thinks your mother has a dementia — a condition where thinking skills decline enough that everyday independence is affected. We look at the pattern over months to years, not one bad hospital night.” [1]

Acute behaviour. “In hospital, infection, pain, strange environment, and disrupted sleep can cause an acute confusional state on top of dementia. Treating pneumonia and settling the environment often helps more than psychiatric sedatives.” [3]

Non-drug plan. “We prioritise comfort, familiar faces, hearing aids, toilets, pain relief, and calm routines. Medicines for behaviour are not the first step.” [3]

Cognitive drugs. “If this is Alzheimer-type disease, tablets such as donepezil or, in later stages, memantine can give modest help with thinking or function for some people. They do not reverse the disease. We start low, watch for side effects like stomach upset or slow pulse, and review whether they help.” [4]

Antipsychotic caution. “Antipsychotics are not routine ‘dementia sedatives’. Studies show a higher risk of death in older people with dementia who take them. We use them only if someone is severely distressed or unsafe after other measures, at the lowest dose for the shortest time, and we talk that risk through openly.” [2]

Home and capacity. “Wanting to go home matters. We assess decision-making for each issue — understanding options, appreciating risks, weighing them, and expressing a choice. If she cannot decide about a complex plan, the law uses substitute decision-makers in a least-restrictive way. Placement is about safety and support needs, not blame.” [5]

Close. Summarise, invite questions, offer leaflet/memory clinic follow-up, named contact. [1]