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Nonpharmacological approaches for behavioural and psychological symptoms of dementia in older adults: A systematic review of reviews

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  • Laura E Legere
  • Susan McNeill
  • Lori Schindel Martin
  • Michelle Acorn
  • Diana An

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.

Suggested Citation

  • Laura E Legere & Susan McNeill & Lori Schindel Martin & Michelle Acorn & Diana An, 2018. "Nonpharmacological approaches for behavioural and psychological symptoms of dementia in older adults: A systematic review of reviews," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(7-8), pages 1360-1376, April.
    • Handle: RePEc:wly:jocnur:v:27:y:2018:i:7-8:p:e1360-e1376
    DOI: 10.1111/jocn.14007
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    References listed on IDEAS

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    1. Wendy Moyle & Jenny E Murfield & Siobhan O’Dwyer & Sierra Van Wyk, 2013. "The effect of massage on agitated behaviours in older people with dementia: a literature review," Journal of Clinical Nursing, John Wiley & Sons, vol. 22(5-6), pages 601-610, March.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    1. Carolina Pinazo-Clapés & Sacramento Pinazo-Hernandis & Alicia Sales, 2020. "Effects of an Educational Program for Professional Caregivers on Behavioral Alterations in Nursing Home Residents: Pilot Study," IJERPH, MDPI, vol. 17(23), pages 1-13, November.

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