Laura E Legere1, Susan McNeill1, Lori Schindel Martin2, Michelle Acorn3, Diana An1. 1. Registered Nurses' Association of Ontario (RNAO), Toronto, ON, Canada. 2. Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada. 3. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
Abstract
AIMS AND OBJECTIVES: To review the evidence on nonpharmacological approaches to care for behavioural and psychological symptoms of dementia in older adults. BACKGROUND: Dementia is increasing in worldwide prevalence and can have severe and life-altering impacts on older adults. Behavioural and psychological symptoms of dementia can occur as a result of unmet needs and are distressing for family and caregivers. Many reviews have examined specific approaches to behaviours, but few have compared interventions for effectiveness and applicability across settings. DESIGN: Systematic review of reviews. METHODS: The search was limited to reviews that were published between October 2009-April/May 2015. Seven databases were searched, and reviews with a focus on nonpharmacological approaches to behaviours in older adults with dementia were included. All reviews were independently screened by two reviewers, quality appraised and data extracted. Results are reported through narrative synthesis. RESULTS: There were 18 international reviews that met inclusion criteria describing individual therapies, targeted interventions and organisational interventions. The organisational interventions of care planning using a consultation or dementia mapping process demonstrated modest benefits. The most conclusive evidence supported individual, sensory-focused interventions such as music therapy, interventions targeting pain, person-centred approaches and education for family caregivers. CONCLUSIONS: Although there remains a paucity of high-quality research in this area, the existing evidence indicates that behavioural and psychological symptoms of dementia require a range of nonpharmacologic sensory-focused approaches that are tailored to the individual. Further research is needed to determine the interventions best suited for specific behaviours and contexts, particularly inappropriate sexual behaviours. RELEVANCE TO CLINICAL PRACTICE: There is a need for nurses to be informed of best practices in order to effectively plan appropriate interventions to address behaviours in older adults with dementia. Care planning and tailored, sensory-focused, nonpharmacologic approaches are safe and effective options for nurses to consider in practice.
AIMS AND OBJECTIVES: To review the evidence on nonpharmacological approaches to care for behavioural and psychological symptoms of dementia in older adults. BACKGROUND:Dementia is increasing in worldwide prevalence and can have severe and life-altering impacts on older adults. Behavioural and psychological symptoms of dementia can occur as a result of unmet needs and are distressing for family and caregivers. Many reviews have examined specific approaches to behaviours, but few have compared interventions for effectiveness and applicability across settings. DESIGN: Systematic review of reviews. METHODS: The search was limited to reviews that were published between October 2009-April/May 2015. Seven databases were searched, and reviews with a focus on nonpharmacological approaches to behaviours in older adults with dementia were included. All reviews were independently screened by two reviewers, quality appraised and data extracted. Results are reported through narrative synthesis. RESULTS: There were 18 international reviews that met inclusion criteria describing individual therapies, targeted interventions and organisational interventions. The organisational interventions of care planning using a consultation or dementia mapping process demonstrated modest benefits. The most conclusive evidence supported individual, sensory-focused interventions such as music therapy, interventions targeting pain, person-centred approaches and education for family caregivers. CONCLUSIONS: Although there remains a paucity of high-quality research in this area, the existing evidence indicates that behavioural and psychological symptoms of dementia require a range of nonpharmacologic sensory-focused approaches that are tailored to the individual. Further research is needed to determine the interventions best suited for specific behaviours and contexts, particularly inappropriate sexual behaviours. RELEVANCE TO CLINICAL PRACTICE: There is a need for nurses to be informed of best practices in order to effectively plan appropriate interventions to address behaviours in older adults with dementia. Care planning and tailored, sensory-focused, nonpharmacologic approaches are safe and effective options for nurses to consider in practice.
Authors: Kurt Kroenke; Sujuan Gao; Kelly M Mosesso; Susan E Hickman; Laura R Holtz; Alexia M Torke; Nina M Johnson; Greg A Sachs Journal: J Palliat Med Date: 2022-03-29 Impact factor: 2.947
Authors: Vivian Welch; Omar Dewidar; Elizabeth Tanjong Ghogomu; Salman Abdisalam; Abdulah Al Ameer; Victoria I Barbeau; Kevin Brand; Kisanet Kebedom; Maria Benkhalti; Elizabeth Kristjansson; Mohamad Tarek Madani; Alba M Antequera Martín; Christine M Mathew; Jessie McGowan; William McLeod; Hanbyoul Agatha Park; Jennifer Petkovic; Alison Riddle; Peter Tugwell; Mark Petticrew; Jessica Trawin; George A Wells Journal: Cochrane Database Syst Rev Date: 2022-01-18
Authors: Carolina Pinazo-Clapés; Sacramento Pinazo-Hernandis; Alicia Sales Journal: Int J Environ Res Public Health Date: 2020-11-28 Impact factor: 3.390