A 86-year-old man with severe Alzheimer's disease (MMSE 6/30) has been living in a care home for 2 years. He is no longer able to recognise his family...

Question

A 86-year-old man with severe Alzheimer's disease (MMSE 6/30) has been living in a care home for 2 years. He is no longer able to recognise his family. Over the past month, he has developed repetitive vocalisation (shouting 'help' repeatedly), resisting personal care, and hitting staff during washing. He has no obvious source of pain (Abbey Pain Scale 3 - mild) and no evidence of delirium (4AT 1). What is the MOST appropriate first-line approach?

Accepted Answer

Conduct a comprehensive assessment for unmet needs: review for pain, constipation, urinary retention, environmental triggers, sensory deficits, and carer approach; implement person-centred care interventions

Answer

Start Risperidone 0.25 mg BD immediately

Answer

Prescribe Lorazepam 0.5 mg PRN for agitation

Answer

Transfer to a psychiatric ward for behavioural management

Answer

Increase his Donepezil dose

uk-dgm MCQ (SBA): Unmet Needs Assessment in Severe BPSD