A Toolkit for Promoting Positive Behavior in Dementia Patients

Toolkit for dealing with dementia

High Risk of Institutionalization

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, this adds to the already hefty arsenal of drugs currently taken by most senior citizens. Obviously, we should not enter into this lightly since they are often accompanied by significant and dangerous side effects.  Clearly, we need better mechanisms for handling these dementia patients.

Toolkit with Best Practices

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. They went 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“.

Additional Approaches

This effort 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”. Please click on these links to explore their work.

As with everything, we need to be advocates for our loved ones. Take time to investigate the latest best practices for dementia patients. This can yield a better quality of life for both the dementia patients. Consequently, those around them will benefit as well. We owe it to our seniors and their loved ones/caregivers to explore any adjunct or replacement treatments. As always, the end goal is to alleviate the often devastating symptoms of Alzheimer’s and dementia.  This handy tool is worth a look.

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Consider Non-Pharmacologic Approaches for Treating Symptoms of Dementia

Behavioral & Psychological Symptoms of Dementia (BPSD)

Many people think of dementia impacting cognitive impairment, like memory loss and attention, but dementia is not just memory loss.  However, there are behavioral and psychological symptoms of dementia (BPSD) that occur in about 90 percent of dementia patients.  Moreover, these 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:

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  • 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

Implications of BPSD Symptoms

Symptoms of BPSD are significantly concerning because they put patients at higher risk for institutionalization, greater functional decline, and domestic abuse.  Until now, 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 may just be a better way. 

Non-Pharmacological Treatments for BPSD

It is important to realize that there are many non-pharmacological treatments that may be helpful.  Furthermore, there is evidence that supports using these approaches despite the existence of inconsistent clinical research.

Notably, some examples of these treatments 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

For further information, click this link for the Nursing Home Toolkit  Non-Pharmacological Approaches to Address Behaviors detailing the most up to date non-pharmacologic approaches for treating BPSD.

Also, take a look at:

Review of Non-pharmacologic Approaches for Treating Behavioral and Psychological Symptoms of Distress

Efficacious and Feasible Non-pharmacological Approaches for Behavioral and Psychological Symptoms of Distress

With so much new research, we owe it to our elderly dementia to consider medication as a measure of last resort.

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