Nonpharmacological management of behavioral and psychological symptoms of dementia: what works, in what circumstances, and why?
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Date
2018
Authors
Caspar, Sienna
Davis, Erin D.
Douziech, Aimee
Scott, David R.
Journal Title
Journal ISSN
Volume Title
Publisher
Oxford University Press
Abstract
Objective: Behavioral and psychological symptoms of dementia (BPSD) refer to the often distressing, noncognitive symptoms of dementia. BPSD appear in up to 90% of persons with dementia and can cause serious complications. Reducing the use of antipsychotic medications to treat BPSD is an international priority. This review addresses the following questions: What nonpharmacological interventions work to manage BPSD? And, in what circumstances do they work and why? Method: A realist review was conducted to identify and explain the interactions among context, mechanism, and outcome. We searched electronic databases for empirical studies that reported a formal evaluation of nonpharmacological interventions to decrease BPSD. Results: Seventy-four articles met the inclusion criteria. Three mechanisms emerged as necessary for sustained effective outcomes: the caring environment, care skill development and maintenance, and individualization of care. We offer hypotheses about how different contexts account for the success, failure, or partial success of these mechanisms within the interventions. Discussion: Nonpharmacological interventions for BPSD should include consideration of both the physical and the social environment, ongoing education/training and support for care providers, and individualized approaches that promote self-determination and continued opportunities for meaning and purpose for persons with dementia.
Description
Sherpa Romeo yellow journal. Open access article. Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0) applies
Keywords
Alzheimer disease , Antipsychotics , Behavior management , Nonpharmacological interventions , Behavioral and psychological symptoms of dementia , BPSD
Citation
Caspar, S., Davis, E.D., Douziech, A., & Scott, D. R. (2018). Nonpharmacological management of behavioral and psychological symptoms of dementia: What works, in what circumstances, and why? Innovation in Aging, 1(3), 1-10. doi:10.1093/geroni/igy001