Australia operates an advanced long term care sector, with proportionately high levels of government funding and advanced systems to support access, quality and public disclosure.

A small yet essential aspect of this system is the Commonwealth supported Specialist Dementia Care Units. By way of numbers there are 2,600 long term care facilities in Australia, and only 26 of these have a Specialist Dementia Care Unit. Hall & Prior a long term care provider based in Perth, Australia operate 2 of these 26 units.

 

This presentation will highlight the contribution that Behaviour Specialist Units contribute on the care of people with dementia.

 

The paper will examine the development and operation of two Western Australian SDCP units. We discuss their development, governance, and therapeutic approach, including the function of behaviour specialists and the target of psychogeriatric involvement. The presentation will highlight

• Referral criteria and processes, with a focus on Tier 6 & 7 behaviours as measured by the Seven-tiered model of behavioural and psychological symptoms of dementia (Brodaty, Draper and Low, 2003)

• Considerations around physical design and commissioning of the units, with a focus on the use of best practice design principles for both resident care, and staff safety

• Challenges associated with recruitment, training, retention of staff who work in the specialist units

• Governance frameworks

• Clinical performance, resident and family satisfaction

• Recommendations in an international context

 

Background

 

The rationale for Specialist Dementia Care Units:

• Older people with complex behavioural and psychological symptoms of dementia (BPSD) (which may also be described as responsive behaviours associated with dementia) typically have complex care needs that are beyond the resources of mainstream long term care settings.

• The Australian Commonwealth Government introduced the Specialist Dementia Care Program (SDCP) as an intensive, multidisciplinary service for individuals with the most extreme and enduring of these behaviours.

Purpose of Behaviour Specialist Units in Dementia Care. SDCUs are designed to;

• Support individuals with severe BPSD, such as aggression, agitation, psychosis, or extreme resistance to care.

• Provide short-term (up to 12 months), intensive intervention, usually as part of a broader care pathway.

• Stabilize behaviours to enable the person to return to a less restrictive environment or long-term care setting.

 

Key Features of SDU

• Multidisciplinary Teams: The therapeutic approach within the units is anchored by a multidisciplinary team consisting of Clinical Nurse Specialists, Registered Nurses, Occupational Therapists, and trained support workers. In a critical role, each unit is managed by a consulting psych-geriatrician, who offers diagnostic expertise, helps with case review, and advises on treatment.

• Individualised Behaviour Support Plans: Behavioural interventions are guided by full functional assessments and carried out with frequent consultation with residents’ relatives and carers, providing a person-centered approach.

• Non-Pharmacological Interventions: Emphasis on behavioural therapies, environmental modifications, and psychosocial supports over medication.

• Safe, Structured Environments: Designed to minimize triggers and support calm, familiar routines.

Benefits of Specialist Behaviour Units

• Improved quality of life for residents through better symptom management.

• Reduced use of restraints and psychotropic medications.

• Enhanced support for caregivers and families, who often struggle with the emotional and physical burden of severe dementia symptoms.

• Reduced hospital admissions and emergency room visits.

Libby Simpson (RN) is an experienced leader in the aged care and disability sectors.

 

Since qualifying as a Registered Nurse in the 1980s, Libby had clinical experience across the acute and tertiary sectors, before dedicating her 30 year professional career to the aged and disability sectors.

 

Libby has a passion for caring for vunerable persons, including people with dementia. Libby is driven by data led decision making and creating the next generation of leaders