The Time is Now to Address Behavioral Symptoms of Dementia

Start time
10:00 AM Pacific
End time
11:00 AM Pacific


Part of the Generations Education Series funded in part by the Archstone Foundation

Endorsed by ASA’s Mental Health and Aging Network (MHAN)


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Includes Complimentary CEUs.

This web seminar is based on the Fall 2014 issue of Generations, "Aspects of Mental Health and Aging. 

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As opposed to core cognitive symptoms, it is the behavioral symptoms of dementia that tend to create the most difficulties for individuals with dementia, their caregivers, and healthcare providers. These manifestations are among the most complex, stressful, and costly aspects of care, leading to frequent hospitalizations, early nursing home placement, and increased mortality. Nevertheless, the increased recent national focus on Alzheimer’s Disease and related dementias has all but ignored behavioral symptoms: There is no national strategy to address these symptoms. While healthcare providers are exhorted by CMS and others to reduce antipsychotic use due to poor risk-benefit ratios, providers and staff lack access to training programs or approaches for assessing and managing behavioral symptoms of dementia.

In this web seminar, we will describe an algorithmic approach called DICE, which stands for Describe, Investigate, Create and Evaluate. DICE is derived from a multidisciplinary national expert panel. It is an evidence-informed approach designed to detect and manage behavioral symptoms of dementia, while considering possible etiologies, and integrating pharmacologic and nonpharmacologic treatments. It also is designed for healthcare providers to implement in the real world, in a variety of settings. We will also discuss applying DICE in different settings and the role of health and human service professionals in the DICE process.

Participants in this web seminar will be able to:

  • Recognize the types of behavioral symptoms commonly encountered by healthcare providers: psychosis; agitation; aggression; depression; anxiety; apathy; disinhibition; motor disturbances; nighttime behaviors and eating problems;
  • Understand the various etiologies that can cause behavioral symptoms, including brain changes; medical issues; unmet needs; preexisting psychiatric illness; caregiver factors; and environmental triggers;
  • Understand that there is no ‘one size fits all’ treatment approach, given the etiologic complexity of behavioral symptoms. Approaches require tailored patient- and caregiver-centered strategies; and,
  • Name the four key components of the DICE approach to assessing and managing behavioral symptoms of dementia.


Dr. Helen Kales is a geriatric psychiatrist, professor of psychiatry and director of the Program for Positive Aging at the University of Michigan. She is recognized as a national expert in outcomes related to depression in later life, as well as those associated with the behavioral symptoms of dementia, and in research related to the risks of use of antipsychotic medications in patients with dementia. 

Dr. Laura Gitlin is an applied research sociologist and professor in the School of Nursing, Department of Community Public Health with joint appointments in the Department of Psychiatry and Division of Geriatrics and Gerontology, School of Medicine, Johns Hopkins University. She is also founding director of the Center for Innovative Care in Aging and is an international expert in behavioral interventions, having conducted 20 trials in family caregiving, nonpharmacologic approaches to dementia care, physical frailty, and depression care.