A Toolkit for Promoting Positive Behavior in Dementia Patients

Toolkit for dealing with dementia

About 5 million Americans have Alzheimer’s Disease and 90% of those are abusive.  This is important because this situation puts these patients at higher risk for institutionalization, greater functional decline and domestic abuse.  Up to this point, the preferred method for managing the Behavioral and Psychological Symptoms of Dementia (BPSD) has been to prescribe medication to control it.  However, adding to the already hefty arsenal of drugs currently taken by most senior citizens is not to be entered into lightly since they are often accompanied by significant and dangerous side effects.  Clearly, we need better mechanisms for handling these patients.

An article in January/February 2014 issue of Geriatric Nursing entitled “Promoting Positive Behavioral Health:  A Non-Pharmacological Toolkit for Senior Living Communities” unearths a great find:  a toolkit which was peer reviewed and endorsed by experts and designed to centralize the most up to date best practices for handling these challenging situations.  A team of clinicians assembled data on how to deal with BPSD beyond the parameters of the antipsychotic medications normally prescribed.  The goal is for these methods to be the first course of action in treating dementia.  The toolkit can be accessed at http://www.nursinghometoolkit.com/ and you can navigate through the tabs on top and get to an area of interest.  Searching through the site will yield a plethora of information including non-pharmacological approaches to dealing with dementia. A helpful graph of approaches can be found in a document entitled “Review of Non-pharmacological Approaches for Treating Behavioral and Psychological Symptoms of Dementia“.

This meshes with a program which began in March 2012 by the Centers for Medicare and Medicaid Services (CMS), the “Initiative to Improve Behavioral Health and Reduce Antipsychotic Use in Nursing Homes” where it partnered with associations such as the American Medical Directors Association (AMDA)  for a comprehensive approach for limiting the use of dementia controlling medications in this population as part of their overall “Partnership to Improve Dementia Care in Nursing Homes”.

We owe it to our seniors and their loved one and caregivers to explore any adjunct or replacement treatments to alleviate the often devastating symptoms of Alzheimer’s and dementia.  This handy tool is worth a look.


Consider Non-Pharmacologic Approaches for Treating Symptoms of Dementia

Many people think of dementia impacting cognitive impairment, like  memory loss and attention, but dementia is not just memory loss.  There are behavioral and psychological symptoms of dementia (BPSD) occur in about 90 percent of dementia patients.  The non-cognitive symptoms are equally important to the syndrome with respect to function and cognition.

BPSD symptoms can be very distressing for the person with dementia, their family and caretakers.  Some examples of these symptoms include: 178086703

Mood Disorders (aggression, depression, anxiety, and apathy)

  • Psychotic Episodes (delusions and hallucinations) 
  • Abnormal Motor Behaviors (pacing, wandering, repetitive vocalization)
  • Inappropriate Behavior (agitation, disinhibition, screaming and elation).
  • Sleep and Appetite Changes

These symptoms are significant because they put patients at higher risk for institutionalization, greater functional decline, and domestic abuse.  To this point, the preferred method for managing BPSD has been to prescribe medication.  However, that adds to the already hefty arsenal of drugs currently taken by most senior citizens, and adds to the potential for dangerous side effects. 

Fortunately, there are many non-pharmacological treatments that may be helpful.  And despite receiving weak support from inconsistent clinical research, there is evidence supporting these approaches.  Some examples are:

  • Sensory Stimulation
  • Environmental Modification
  • Behavioral Therapy
  • Cognitive/Emotion-Oriented Approaches
  • Social Contact (real or simulated)
  • Caregiver Training/Development
  • Structured Activities
  • Clinically-Oriented Approaches
  • Individualized/Person-Centered Care
  • Clinical Decision Support Approaches

Click the links below to see a Toolkit detailing the most up to date non-pharmacologic approaches for treating BPSD.  https://googledrive.com/host/0B5mkUGmS3zi7T1hiRTZ2OEVTb0U/Non_iframe_1.html


We owe it to our elderly dementia to consider medication as a measure of last resort.

For more information and assistance with treating dementia patients contact David York Agency at 718-376-7755.  And visit our website at http://davidyorkhomehealthcare.com/.