/p>>an article of Marta Martin Hernandez, psychologist at the Casillas del Ángel Residence for the Elderly (Fuerteventura), and Clara Luque Jimenezpsychologist and director of the same center managed by
The psychological and behavioral symptoms (SPCD) are mental symptoms made up of emotional, behavioral and thinking disturbances, which can be observed both before a dementia as during the course of it. It is observed very frequently in the elderly, so what is common both in the family environment and in the residential environment is that these signs are the most consulted with professionals.
The emotional disturbances best known are depression, anxiety or anxiety and depression (combined), which on many occasions can be intrinsic or associated with the cognitive decline, and in other cases, independent of it. These alterations are very annoying for the person, generating negative emotions and cognitions, and in turn, suffering and anguish.
On the other hand, behavioral alterations usually have a most social disruptive component, and they can be of two types: due to excessive activity or behavior, such as shouting, aggressiveness, repetitive verbal or motor actions, wandering, social and/or sexual disinhibition, aberrant behavior, etc. By default: apathy, inhibition, negativism,… Or a combination of both. Being in some situations the person very active and others presenting a low response rate.
Third, there are the thought disturbancessuch as delusions and hallucinations, which are limiting for the user’s relationship with his personal and social environment.
This categorization of alterations is still a way of organizing or classifying them, since the emotional and thought componentsare directly related to the behaviors, whether due to excess or deficiency of the same.
On many occasions, these symptoms make it possible to observe a change in the person in order to investigate and evaluate whether there is a deterioration in their cognitive abilities or if they are due to another reason, be it the organization of the physical and/or social space, or even medical reasons. . For what they serve, as alarm signal of a possible neuropathological change.
The how to address these changes includes many factors. If we focus attention on the non-pharmacological (whenever possible), we will address the problem situation by doing a symptom assessment first. The specific scales, the systematized observation and the information provided by informants (caregivers and family members) are useful to evaluate them. Once this information is obtained, it is possible to understand the possible factors that trigger it. Which will allow designing the best way to intervene according to the specific characteristics of the problem and the singularities of the user.
It is essential that the design of the intervention take into account the personal factors, tastes and personality of the person to whom it is addressed. Interventions can be group or individual, depending on the proposed objective.
At times when the user needs to correct behaviors that limit their interaction with others, either due to disruptive behavior such as social disinhibition, or by default, for example apathy, it is useful to use techniques and therapies that are carried out through a group methodology, which allows reinforcing and training behaviors and social skills. Group therapies are essential to avoid social isolation that is very common in older people. The individual therapies instead, they are programmed to work on specific cognitive alterations, emotional alterations in people with mild impairment and the cognitive component of many of the disorders.
On several occasions, the alterations shown by users indicate a underlying need or demand. The needs can be biological or medical, produced by brain deterioration, a pharmacological decompensation, an undiscovered pathology, etc. As for the demands, they may be related to affective needs, lack of stimuli or activity, deficits in interaction or bonding with others,…
It is important to know that no matter how serious the deterioration is, you should always seek some type of therapeutic resource. That will oscillate between a greater cognitive and behavioral component in dementia or mild cognitive alterations, until reaching a more sensory component and of greater simplicity to stimulate in moderate and severe deterioration.
When the older person presents a mild impairment Different therapeutic strategies can be used for these psychological and behavioral symptoms (SPCD). For example, cognitive stimulation, cognitive training and cognitive rehabilitation are the first therapeutic strategy when the objective is to improve and/or slow down the deterioration of cognitive abilities. External aid is also useful, such as calendars, diaries, communication devices, etc., which make it possible to fill gaps that may be causing discomfort. When you want to work on social skills, inappropriate behaviors or emotional disorders, you can work through techniques of psychotherapy, reminiscences, music therapy, art therapy and leisure therapies, among others.
The behavioral disturbancesin all stages of dementia, require a behavioral intervention They can be addressed through a functional analysis of behavior, physical interventions and space (light, noise) and sensory therapies.
When the dementia progresses and deterioration is greaterr, it is essential to study the environment, use sensory therapies, musical therapies and validation, which allow maintaining the humanization of the elderly at all times.
The sensory and musical therapies, allow to stimulate the user’s most basic senses such as touch, sight, proprioception, hearing, taste and smell. In stages of less deterioration, they are useful for regulating disturbing emotional components for the well-being of the elderly, connecting with previous experiences and promoting the generation of moments of enjoyment and pleasure in the present.
The greater the deterioration, the greater the simplification of sensory activities, while maintaining the sensations that are pleasant to them, and that allow them to reconnect with their body and their environment. All this entails a process of stimulation and tests with different stimuli, until obtaining some type of answer, however simple it may be, being essential and very useful to know tastes and pleasant experiences of the personal life of the elderly.