[A brief reference to this item features in Dementia and Elderly Care: the Latest Evidence Newsletter (RWNHST), Volume 3 Issue 5, January 2013].
Since pharmacological treatment (i.e. antipsychotic medication) for the treatment of behavioural and psychological symptoms of dementia (BPSD) tends to be only modestly effective and has significant risks, the authors of this article recommend first-line non-pharmacologic treatments. These US researchers have developed a six-step flowcharted approach to help in the management of behavioural symptoms in dementia patients, and this essential plan can be applied across different care settings.
Systematic screening for behavioral symptoms in dementia facilitates the early treatment of distressing behavioural symptoms, as a result of paying attention to the “underlying causes” of problematic behaviour and tailoring a suitable treatment plan in each case. This approach makes it easier to address those behaviors which are found distressing by family members and caregivers. BPSD left untreated could otherwise accelerate disease progression, accelerate functional decline for patients and reduce their quality of life, while worsening carers’ distress burden and result in earlier nursing home placement.
Non-pharmacological treatments include provision of caregiver education and support, training in problem-identification and problem-solving, and targeted therapy directed at the underlying causes for specific behaviors (for example, improved bedtime routines to reduce disturbed sleep patterns). This article lists common problematic behavioural symptoms and describes strategies for selecting suitable evidence-based non-pharmacological dementia treatments.
Gitlin, LN. Kales, HC. [and] Lyketsos, CG. (2012). Nonpharmacologic management of behavioral symptoms in dementia. JAMA: the Journal of the American Medical Association, November 21st 2012, Vol.308(19), pp.2020-9. (Click here to view the PubMed abstract).
A readable summary of this research appears in the Nursing Times:
Full Text Link (Note: This article may require a suitable Athens password, a journal subscription or payment for access).
Ford, S. (2012). Nurses promote ‘six-steps’ to manage dementia. Nursing Times, November 30th 2012 (online).