The reality of dementia is that it can make anyone aggressive under certain circumstances.
But it’s not as simple as separating those who are aggressive from those who aren’t, the medical director for tertiary mental health in Interior Health said Wednesday.
“The reality is, dementia can cause anybody to behave in a way that’s atypical for them,” said Dr. Paul Dagg. “Dementia can change people profoundly.”
For example, someone can be aggressive once and never again, another can be peaceful and suddenly turn.
Dagg is based at Hillside Psychiatric Centre in Kamloops, where a 95-year-old Vernon man has been taken for assessment after he allegedly killed his 85-year-old residential-care roommate Sunday night.
While he can’t speak to the specifics of any particular patient, Dagg was able to explain in general terms how dementia can affect people and what is being done for them.
Dementia will affect about 14 per cent of people over the age of 71, he said. It includes a range of behavioural and psychiatric symptoms, including confusion, irritability and changes in mood and there are times when things can trigger aggressive behaviour.
When dementia becomes apparent, it’s important to have a thorough assessment, he said.
But hospitals are under pressure to get people treated and released as quickly as possible, so they’ll deal with someone’s pneumonia but not necessarily psychological issues.
“They don’t always take the holistic view of the person to deal with these behavioural changes,” said Dagg.
“We are doing things in IHA to address this and we’re fortunate in Kamloops we have a resource like Hillside, which is taking a provincial leadership role with people with dementia. We have a geriatric and neuropsychiatry provincial program.”
B.C. is also implementing a training program from Ontario that teaches residential care staff how to approach clients with behavioural problems. It looks at physical, intellectual, emotional and environmental issues that cause people to change.
But training takes time and money, so the rollout of that program won’t happen overnight, he said.
And the health-care system’s tight budget doesn’t make the provision of mental-health services any easier, Dagg noted.
“There’s an old saying when health-care patches the cold, mental health gets pneumonia.”
There is more he’d like to see B.C. do, like looking at programs in Ontario that target dementia and patient-on-patient violence.
“As a society, we have to recognize this is a challenge we face.”
There are varying methods of treatment, from medication to environmental changes to social interventions. The key is to get treatment for those who need it and realize they have a medical condition, not bad behaviour.
“We can predict a substantial percentage of these, but there are some that are just unpredictable. That’s the challenge we have. We want to predict changes as quickly as possible. There’s no such thing as no risk, we can make things low risk.”