Special Management Problems

  • Rosanne M. Radziewicz
  • Cheryl Bradas


More than two-thirds of individuals with dementia experience behavioral and psychological symptoms of dementia (BPSD) including wandering, sundowning, shadowing, hoarding, aggression, stubbornness and uncooperativeness with care, inappropriate sexual behavior, and repetitive and vocally disruptive behaviors. These behaviors can pose a significant health and safety risk to the older adults as well as to their caregivers. Due to the adverse risk of psychotropic medications in the older adults, individualized non-pharmacological interventions are preferred treatments based on patient-specific history and the needs of the caregivers. In this chapter we review in detail the different management problems in older adults especially among those individuals with dementia.


Behavioral and psychological symptoms of dementia Wandering Sundowning Shadowing Hoarding Aggression Stubbornness and uncooperativeness with care Inappropriate sexual behavior Repetitive and vocally disruptive behaviors 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NursingThe MetroHealth SystemClevelandUSA

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