Support Plan

Stage 1: Identify the target responsive behaviour and liaise with the prescriber

Stage 1: Identify the target responsive behaviour and
liaise with the prescriber

  1. Exclude delirium/depression, adverse drug effects or interactions, infection or pain by liaising with the prescriber.
    Consider a medication review. Refer to appropriate guidelines to manage any identified causes.
  2. If available, contact your in-house dementia specialist for advice regarding first-line non-pharmacological interventions.
    For further advice contact Dementia Support Australia (DSA) on 1800 699 799.
  3. Review and amend the current care plan and ensure a Behaviour Support Plan is in place. Remember to focus on individualised, person-centred care strategies.
  4. Should these measures adequately support the person, maintain care provision using the amended care plan and Behaviour Support Plan, with regular monitoring and review.
  5. If the responsive behaviour cannot be resolved continue to next tab.

Unresolved responsive behaviour

If modification of care provision does not adequately support the person, liaise with the prescriber.

Whilst pharmacological support may be considered at this time; non-pharmacological approaches should be maintained throughout.

An antipsychotic medication should only be considered for use in a person with dementia for:

  1. Distressing psychosis; or
  2. A behaviour that is harmful/severely distressing to the individual or puts others at risk.

Most other symptoms are unlikely to respond to treatment with an antipsychotic medication.

Stage 2: Suggested plan if an antipsychotic is to be trialled

Stage 2: Suggested plan if an antipsychotic is
to be trialled

Suggested Plan

  1. Restrictive practices must only be used as a last resort and in the least restrictive form.
  2. Where restrictive practices are used, approved providers must meet a number of conditions. Refer to the Aged Care Quality and Safety Commission website for the latest information.
  3. Commence antipsychotic medication using a regular low dose.
    Refer to For Prescribers: Starting a Regular Antipsychotic
  4. Monitor for ongoing response and potential side-effects:
    1. If side-effects develop at any stage, immediately contact the prescriber.
    2. Maintain non-pharmacological approaches: refer to allied health.
  5. Review after 2 to 4 days for effectiveness:
    1. If no/inadequate response, contact prescriber and consider increasing the dose.
    2. If tolerated and effective, continue.
DTA reminder stickers are available to assist with trialling a new antipsychotic medication.

Place them in the Communication Book or Resident Notes as appropriate.

Go to www.dta.com.au to download a template for these stickers.
  1. At 1 to 2 weeks, prescriber to review for response and side-effects:
    1. If the antipsychotic is ineffective/not tolerated, cease it. Should an alternative antipsychotic be trialled, return to Step 1.
    2. If the antipsychotic is tolerated and effective, continue.
      Monitor for response and side-effects, maintain non-pharmacological approaches.
    3. Discuss and develop a withdrawal plan with the prescriber.
      Prescriber to initiate withdrawal plan; aiming to cease no later than 12 weeks.
  2. At 6 weeks, prescriber to review for response and side-effects. Repeat Step 4a and 4b. Consider withdrawal if not already initiated.
  3. At 12 weeks, prescriber to review for resolution of the target responsive behaviour.
  4. If the target responsive behaviour reoccurs after dose reduction or cessation.
    Refer to Withdrawal Plan