Management of behavioral and psychological symptoms of dementia in long‐term care facilities in Japan

Abstract

Background: An increasing number of old people, and their medical requirements, cannot be managed by their families in their homes, which has been the traditional and prevalent practice in Japan. The number of people with dementia is increasing and behavioral and psychological symptoms of dementia (BPSD) make care difficult. In the present study, we investigated management techniques for BPSD in long-term care facilities in Japan by using the data mining method, which looks at the reported behaviors of care providers. Methods: First, interviews were conducted with 15 care providers to develop items for a questionnaire. These data were analyzed qualitatively and synthesized with criteria from the professional literature. The resulting self-report questionnaire on techniques used to manage different symptoms of dementia was completed by 275 care providers. We applied the association rule as a data mining method examining 15 management techniques related to 13 BPSD. Results: Analysis identified four types of management techniques: (i) emotional and behavior-concordance techniques; (ii) acceptance and supportive techniques; (iii) restraining techniques; and (iv) avoidance techniques. Different management techniques, and combinations of techniques, were found to vary in use and effectiveness with different BPSD. Conclusions: Good management techniques for many BPSD have been developed and are being implemented by care providers. The present study has the potential to inform researchers and care providers in Japan about the types of management techniques in current use, as well as areas of potential need for staff training.

Apolipoprotein E and central nervous system disorders: Reviews of clinical findings

“…Behavioral therapy, 10 aromatherapy 11 and animal‐assisted therapy 12 are sometimes useful. Different strategies are recommended by the clinical settings either at home 13 or in institutions, 14,15 targeting each type of dementia, including Alzheimer's disease (AD), 2 frontotemporal dementia, 16 diffuse Lewy body disease, 17 and vascular dementia 18 …”

Editorial: New drugs for Alzheimer's disease in Japan

“…Considering the limitations of the drugs available, clinicians should be prepared for the progression of the disease of the patients in the long run. Controlling of behavioral and psychological symptoms of the patients is important for the family and caregivers of the patients 11,18,25–29 . Non‐pharmacological intervention, 12–14,30 a care program, 31 and support of the patients and family 19,32 will be even more important for the treatment of Alzheimer's disease patients.…”

“…The number of Alzheimer's disease patients in Japan is expected to increase to 1.42 million in 2015, 1.67 million in 2020, and 2.2 million in 2025. The prevalence of Alzheimer's disease has increased the need for research aimed at identifying the risk, 3,4 pathogenesis, 5–8 diagnosis, 9 drugs, 10,11 non‐pharmacological intervention, 12–15 care, 16–18 and support 19,20 for this disease. A diverse range of compounds has been evaluated as potential treatments for Alzheimer's disease, and five compounds have been approved in the world for the treatment of Alzheimer's disease.…”

Pharmacogenomics of Alzheimer's disease

“…Behavioral therapy (Narumoto et al , 2009), aromatherapy (Jimbo et al , 2009) and animal‐assisted therapy (Le Roux & Kemp, 2009) are sometimes useful. Different strategies are recommended by the clinical settings, either at home (Kinoshita, 2008) or in institutions (Kutsumi et al , 2009; Tanaka et al , 2009). In view of specific features of Alzheimer's disease (Amano et al , 2009), frontotemporal dementia (Kimura et al , 2009), diffuse Lewy body disease (Kosaka, 2008), and vascular dementia (Chen et al , 2008), some unique trials have been reported.…”