Criteria
28a The care record shows that service users who develop behavioural or psychological dementia symptoms have a review of their care plan within 4 weeks.

28b There is a local system in place for a structured and systematic response to the development of behavioural or psychological dementia symptoms.

28c The care record shows that an appropriate assessment tool has been used to assess the efficacy of medication.

Supporting material for standard 28:
Cognitive impairment is the core feature of dementia but it is often behavioural and psychological changes which contribute more to the difficulties experienced both by the person with dementia and by their carers. Assessment and management approaches need to reflect the range of possible causes of such behaviour and especially the often complex interaction between biological, psychosocial and environmental factors. A comprehensive assessment is required to try to establish factors which may cause, aggravate or improve behavioural problems and also to establish if the problems are serious, and if so to whom.

Areas covered by the assessment should include:
- Physical health
- Pain or discomfort
- Medication side effects
- Depression
- Psychotic symptoms
- Personality/ past experiences and interests
- Environment
- Carer approach
- Behavioural analysis

The assessment should lead to the creation of an individual care plan to help carers address the behavioural problems.