The PIECES TIPS service provides timely fax or e-mail advice on clinical and educational problems to those participating in the comprehensive PIECES Education Program. A team of experts provides the practical TIPS responses and advice for thinking through complex problems.
E-mailed or faxed responses are provided within a short timeframe. TIPS is one component of the on-line PIECES Resource Centre.
There have been over 1200 TIPS collected: the items in our TIPS Library represents FAQ's.
Please note...
- TIPS information should be used similar to the way you would use information from a textbook.
- TIPS responses are not intended to serve as an individual consultation service. You should use this information in context and always work closely with the family physician involved in the care of the client and with other Partners in Care to find solutions to individual client issues.
Below are categories for questions. You will need a PDF reader to view the questions and answers
Q1 What is the behaviour-cognitive/mental health need?
Q1.1 Lifestyle choices affecting health
Q2 Who is it affecting?
Q2.2 Dealing with family concerns
Q2.3 Supporting family
Q2.4 Behaviour that involves stealing
Q2.5 Family resistant to change
Q2.6 Family coping with admission
Q2.7 Family in denial
Q2.8 Staff coping with family in denial
Q2.9 Self-care behaviour concerns
Q2.10 Staff fearful
Q3 What is the degree of risk?
Q3.2 At risk for falls
Q3.4 Degree of risk
Q3.5 High elopement risk
Q3.7 Smoking risk
Q3.8 Loneliness & suicidal expressions
Q3.9 Risk & restraints
Q4 How do we describe & record what we see?
Q4.1 Folstein
Q4.3 Time to do DOS
Q4.6 Cornell Scale Interpretation
Q4.7 DOS assessment with incomplete data
Q4.8 Differentiate between agitation & disease progression
Q4.10 Admission assessment tools
Q4.11 Clock test results
Q4.12 Wandering and rummaging
Q4.13 Assessment Tool
Q4.14 Accuracy of MMSE
Q5 What are the possible causes?
Q5.1 Misidentification & visual agnosia
Q5.2 Sleep disturbance & elderly
Q5.3 Differentiating Delirium & Dementia
Q5.4 Anxiety in Dementia
Q5.5 Depression in Schizophrenia
Q5.6 Sudden Change in behaviour
Q5.7 Rapid decline due to environmental change
Q5.8 Dealing with aggressive behaviour
Q6a What are our best strategies - Interventions?
Q6.1 Aggression management restraints & quality of life
Q6.2 Attention seeking behaviour
Q6.3 Snoezelen rooms
Q6.5 Activities for the cognitively impaired
Q6.6 Dealing with staff attitudes
Q6.7 Best strategies for severe depression
Q6.8 Risk of inappropriate behaviour
Q6.10 Resident refusing care
Q6.11 Chemical restraints
Q6.12 Resident refusing care 1
Q6.13 Interventions for unpredictable behaviour
Q6.14 Meds sensitivity
Q6.15 Chemical restraints 1
Q6.16 Best care strategies
Q6b What are our best strategies - Psychotropics?
Q6.17 Benzodiazepines
Q6.18 Lewy Body and Benzodiazepines
Q6.19 Lewy Body Dementia
Q6.20 Anxiety in the elderly
Q6.21 Anxious - oral medication
Q6.22 Antidepressant continue, discontinue
Q6.23 Effexor and dementia & depression
Q6.24 Timing of antidepressant
Q6.25 Cholinergic and anticholinergic dilemma
Q6.26 Nausea and antidepressants
Q6.27 Psychotropics & Alzheimer Disease
Q6.28 Depressive syndrome & dementia
Q6.29 Lewy Body and Sinemet
Q6.30 EPS and Atypicals
Q6.31 Antidepressants for how long
Q6.32 Antidepressants & response
Q6.33 Na Valporate
Q6.34 Levels of Na Valporate
Q6.35 Na Valporate levels - what causes elevation
Q6.36 Dosing and disorders and atypicals
Q6.37 Yelling and Psychotropics
Q6.38 Anxiety-agitation choice of treatment
Q6.39 Injectable antipsychotic - long acting to atypical
Q6.40 Seroquel oral dose
Q6.41 Psychotropics oral dose
Q6.42 Sexual dysfunction
Q6.43 EPS-Risperidal
Q6.44 Withdrawal of antipsychotics
Q6.45 Agitation Aggression
Q6.46 Oral dissolving meds
Q6.47 Aricept and use
Q6.48 Aricept and behaviour
Q6.49 Aricept and LTCF
Q6.50 Cognitive enhancer benefits
Q6.51 Cholinergics - when, where A
Q6.52 Cholinergics - when, where B
Q6.53 Screaming
Q6.54 Galantamine use
Q6.55 Cholinergics - place of resident
Q6.56 Lewy Body Treatment
Q6.57 Schizophrenia & Cognition
Q6.58 Aricept - drug interactions
Q6.59 Monitoring Cholinergics
Q6.60 Psychotropics PRN
Q6.61 Acquired Brain Injury & medication
Q6.62 Screaming and psychotics after ruling out other causes
Q6.63 Weight and cognitive enhancer
Q6.64 Drug Free Day
Q6.65 Cognitive enhancer for what type of dementia
Q6.66 Cognitive Enhancer & dementia
Q6.67 Cognitive Enhancer - at what stage of dementia
Q6.68 Cognitive enhancer - mod to severe dementia
Q6.69 Doses of antipsychotics
Q6.70 Antidepressants & dose
Q6.71 Behaviour and Psychotropics
Q6.72 Myasthenia Gravis treatment with cholinesterase
Q6.73 Tardive Dyskinesia
Q6.74 Renal dysfunction & antipsychotics
Q6.75 Sleep and cognitive enhancers
Q6.76 Switching Antipsychotics
Q6.77 Antipsychotics & time of onset
Q6.78 Trying new medicine - the family doctor & you
Q6.79 Medication effective but side effects increased
Q6.80 Haldol - use & side effects
Q6.81 Antidepressant losing efficacy
Q6.82 Celexa or colitis cause of diarrhea
Q6.83 Discontinuing Zyprexa
Q6.84 Side effects of antipsychotics
Q6.85 Using antipsychotics PRN
Q6.86 Critical questions in psychopharmacology
Q6.87 Antidepressants & morphine
Q6.88 Grief vs. depression & when to use antidepressants
Q6.89 Pacing exit seeking meds
Q6c What are our best strategies - General?
Q6.90 Dealing with family concerns
Q6.91 Assessing extent of dementia communicating to family
Q6.92 Calling out behaviour
Q6.93 Strategies to deal with personality disorder
Q6.94 Procedure for moving to locked unit
Q6.95 Mental stimulation for blind ABI resident
Q6.96 Verbally inappropriate behaviour
Q6.97 Managing behaviours
Q6.98 Exiting behavior
Q6d What are our best strategies - Implementation?
Q6.99 Ensure the continuity of a successful intervention
Q6.100 P.I.E.C.E.S. on admission
Q6.101 Partners in Care
Q6.102 Dedicated time for assessments
Q6.103 Monitoring Trends in Psychotropic Use
Q6.104 Continuity & Temporary Staff
Q6.105 Teams Taking Action
Q6.106 Maintaining continuity of care
Q6.107 Admission of congenital MH residents
Q6.108 Adequate care and adminstrative support
Q6.109 Implementing P.I.E.C.E.S
Q6.110 Assessment process in team model
Q6.111 Time for assessments