The effects of emotion-oriented approaches in the care for persons suffering from dementia: a review of the literature.

OBJECTIVE: This article presents an overview of the results of intervention studies in various emotion-oriented approaches in the care for people suffering from dementia. Recommendations are made with regard to clinical practice and future research. DATA SOURCES: We searched for references (1990-99) in several bibliographical databases, i.e. Medline, PsycLit, Embase, Sociofile and Current Contents. The terms 'dementia' and 'Alzheimer's disease' were linked separately to the search terms: emotion-oriented, validation (therapy), sensory integration/sensory stimulation/snoezelen, simulated presence therapy and reminiscence (therapy)/life-review. Based on references in the articles found, other publications were traced. STUDY SELECTION: We started from the 'emotion-oriented' approaches used in 24-hour care distinguished by the American Psychiatric Association (1997) i.e. validation, sensory stimulation/integration, simulated presence therapy and reminiscence. We selected research articles that describe intervention, design, measuring instruments and results. DATA EXTRACTION: The articles were analyzed with regard to research group, setting, design, effect variables, intervention, measuring instruments, statistical analyses and results. DATA SYNTHESIS: It is shown that mainly positive results (including increased social interaction and decrease of behavior problems) are achieved with these emotion-oriented approaches. Unfortunately many studies have methodological limitations and are done independently, which makes comparison difficult.
CONCLUSIONS: Despite the limited cogency of the studies we traced, the results are promising. Emotion-oriented care approaches offer the opportunity to tailor the care to the individual needs of dementing elderly and can be complemented with other psychosocial approaches (e.g. psychomotor therapy and music therapy) when necessary. The challenge for the care sector is to develop guidelines to determine which approach should be applied to whom and when. Scientific research can contribute by examining which emotion-oriented approaches, possibly in combination with each other or with psychosocial therapies, effect an increase in the well-being and improve functioning in which patients. Copyright 2000 John Wiley & Sons, Ltd.