Behavioural and psychological symptoms of dementia and their management in care homes within the East of England: a postal survey

Backhouse, Tamara; Penhale, Bridget; Burns, Diane; Gray, Richard

doi:10.1080/13607863.2013.819834

Cited by 25 publications

(35 citation statements)

References 15 publications

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“…Table 2 shows the characteristics of the 4 case study care homes. Care staff on AM shift** 6 4/5 7 8/9 Care staff on PM shift** 6 4 7 7 Care staff on night shift** 2 2 4 4 *Information from a postal survey prior to the case studies [32] **Includes carers and nurses/seniors on shift, but excludes management, activity, maintenance, office and domestic staff The blurring between non-pharmacological interventions and activities Table 3 shows the wide variety of NPIs or activities which were found to be used in the four care homes. The observation data showed that activities were used in several ways.…”

Section: Discussionmentioning

confidence: 99%

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The use of non-pharmacological interventions for dementia behaviours in care homes: findings from four in-depth, ethnographic case studies

2016

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BackgroundAntipsychotic medications have been used to manage behavioural and psychological symptoms of dementia (BPSD). Due to the potential risks associated with these medications for people with dementia, non-pharmacological interventions have been recommended as safer alternatives. However, it is unknown if, or how, these interventions are used in care homes to help people experiencing BPSD. AimTo explore the use of non-pharmacological interventions in care homes to manage behavioural and psychological symptoms of dementia. MethodsIn-depth, ethnographic case studies were conducted in 4 care homes; in total they included interviews with 40 care-home staff and 384 hours of participant observations. FindingsNon-pharmacological interventions, some of which are the focus of efficacy research, were used in care homes, but predominantly as activities to improve the quality of life of all residents and not identified by staff as meeting individual needs in order to prevent or manage specific behaviours. Socially relevant activities such as offering a cup of tea were used to address behaviours in the moment. Residents with high levels of need experienced barriers to inclusion in the activities. ConclusionsThere is a gap between rhetoric and practice with most non-pharmacological interventions in care homes used as social activities rather than as targeted interventions. If nonpharmacological interventions are to become viable alternatives to antipsychotic medications in care homes further work is needed to embed them into usual care practices and routines. Training for care-home staff could also enable residents with high needs to gain better access to suitable activities.2

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Section: Discussionmentioning

confidence: 99%

“…The results of a previous postal survey to care-home managers [32] were used to select suitable homes to target for the purposive sampling of the case studies. All eligible survey responses were analysed and sorted (n=291) and those homes most likely to be caring for people experiencing BPSD were selected as potential sites (n=80).…”

Section: Samplingmentioning

confidence: 99%

The use of non-pharmacological interventions for dementia behaviours in care homes: findings from four in-depth, ethnographic case studies

2016

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“…In the meta‐analysis by Sitzer, Twamley, and Jeste, it was stated that the effect size of cognitive training interventions was medium, patients gained cognitive and functional benefits, and cognitive training had positive effects on learning, memory, functionality, and daily activities . In another study on nonpharmacological implementations applied in nursing, houses in England were evaluated using a form developed by the researchers; therapies (64%) were commonly used among nonpharmacological practices applied for Alzheimer's and other types of dementia …”

Section: Introductionmentioning

confidence: 99%

“…6 In another study on nonpharmacological implementations applied in nursing, houses in England were evaluated using a form developed by the researchers; therapies (64%) were commonly used among nonpharmacological practices applied for Alzheimer's and other types of dementia. 7 Reminiscence group therapy is defined as vocal or silent recall of life events performed in the presence of a group. Reminiscence group therapy involves the discussion of past activities, events, and experiences, usually with the aid of tangible prompts.…”

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confidence: 99%

The effect of reminiscence therapy on cognitive functions, depression, and quality of life in Alzheimer patients: Randomized controlled trial

Lök

Bademli

Tosun

2018

Int J Geriat Psychiatry

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Background Alzheimer is a disease leading to various neuropsychiatric behavioral disorders, and the most common symptom observed during the prognosis of Alzheimer's disease is dysmnesia. The aim of the present study is to investigate the effect of reminiscence therapy on cognitive functions, depression, and quality of life in Alzheimer's patients. Methods The present study was a randomized controlled single blind study with two groups, which was designed in the experimental pretest‐posttest pattern in the city of Konya, Turkey. It was decided to include a total of 60 elderly individuals. Information form that evaluated socio‐demographic characteristics and disease history of individuals in intervention and control groups and was developed by the researcher. Standardized Mini‐Mental State Examination (SMMSE), Cornell Scale for Depression in Dementia, and the Quality of Life in Alzheimer's Disease (QOL‐AD) Scale were used to collect the data. Reminiscence therapy was applied once a week and lasted for 8 weeks. Every session took 60 minutes. Groups consisted of six people. Results Mini‐Mental Test, depression, and quality of life mean scores of the elderly in intervention group before reminiscence therapy program increased after the administration, and the difference was statistically significant (P < 0.05). In the intergroup comparison, a significant difference was found between elderly individuals' posttest Mini‐Mental Test, depression, and quality of life mean scores (P < 0.05). Conclusions Our results suggest that regular reminiscence therapy should be considered for inclusion as routine care for the improvement of cognitive functions, depressive symptoms, and quality of life in elderly people with Alzheimer.

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“…Whether these alternatives are tried before the use of antipsychotics is commenced is unclear. These alternatives could also be used simultaneously with antipsychotics to address severe challenging behaviour, especially as more complex cases need a multi‐level strategy …”

Section: Discussionmentioning

confidence: 99%

Reasons for (not) discontinuing antipsychotics in dementia

et al. 2017

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Background: The gap between high antipsychotic prescription rates for patients with dementia and the guidelines' advice to prescribe cautiously indicates that barriers to discontinuation exist. This exploratory study used the theory of planned behaviour to give a first overview of the factors that influence physicians to discontinue antipsychotics in nursing home patients with dementia. Methods: Forty-one physicians in the Netherlands completed an online survey based on the theory of planned behaviour. Results: Half of the respondents agreed that antipsychotics have positive consequences for patients, such as calming effects. Physicians who indicated that they tend not to discontinue antipsychotics believe that antipsychotics are associated with positive consequences for nursing home staff. Physicians who tend to discontinue antipsychotics had a higher perceived behavioural control than those who indicated having a low intention. Conclusion: To enhance discontinuation of antipsychotics, interventions should focus on both patient-related factors and staff-related factors. Prescribing decisions are influenced by staff-related factors that need to be addressed as well.

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Behavioural and psychological symptoms of dementia and their management in care homes within the East of England: a postal survey

Cited by 25 publications

References 15 publications

The use of non-pharmacological interventions for dementia behaviours in care homes: findings from four in-depth, ethnographic case studies

The use of non-pharmacological interventions for dementia behaviours in care homes: findings from four in-depth, ethnographic case studies

The effect of reminiscence therapy on cognitive functions, depression, and quality of life in Alzheimer patients: Randomized controlled trial

Reasons for (not) discontinuing antipsychotics in dementia

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