Behavioural and psychological symptoms of dementia: a seven-tiered model of service delivery

Henry Brodaty, Brian M Draper and Lee-Fay Low
Med J Aust 2003; 178 (5): 231-234.


  • People with dementia usually experience behavioural and psychological symptoms of dementia (BPSD) during the course of their illness. Currently, in Australia, there is a lack of comprehensive planning for managing and preventing BPSD, and the resources required for optimal care are inadequate and unevenly distributed.

  • We propose a seven-tiered model of service delivery based on severity and prevalence of BPSD, ranging from no dementia through tiers of increasingly severe behavioural disturbance to the propensity for extreme violence in a small number of individuals.

  • Each tier is associated with a different model of intervention. People with dementia may move up or down between tiers depending on their condition, their care and the intervention provided.

  • Lower-level interventions may prevent the need for the more intensive interventions needed when disturbance becomes more severe.

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  • Henry Brodaty1
  • Brian M Draper2
  • Lee-Fay Low3

  • Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW.


Competing interests:

None identified.

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