Non‐pharmacological management of behavioural symptoms in nursing homes

Abstract

The intervention reduced BPSD in severely demented nursing home residents and this effect was still present 3 months after the end of the programme.

Non-pharmacological interventions for aggression in persons with dementia: A 10-year follow-up review of the literature

“…Only five of the studies (42%) reviewed, however, conducted follow-up assessments that ranged from six weeks to six months. [31,33,36,39,42] These findings represent a slight improvement from those of Buchanan et al, [29] who found that only 22% studies included any kind of follow-up assessment. Nevertheless, more studies must assess whether treatment gains maintain over time as the disease progresses and what sorts of modifications are necessary to accommodate this progression.…”

“…Deudon and colleagues [39] conducted a randomized controlled trial in 16 nursing homes with 306 individuals with dementia. An eight-week staff education and training program was completed in the nursing homes with the goal of reducing problem behaviors, including aggression.…”

“…[14,[49][50][51] More recently, three staff intervention studies found significant reductions in aggression. [39][40][41] These programs tend to involve multiple sessions and teach specific skills such as identifying and modifying environmental precipitants of aggression, communication techniques, learning to view problem behaviors as an expression of an unmet need, learning to examine antecedents to aggressive behaviors and their consequences, and distraction. One important feature of some training programs evaluated is that there was an emphasis placed on individualizing intervention strategies based on a "menu" of more general strategies.…”

“…Most notably, only four were randomized control trials that utilized "gold standard" experimental methods such as random assignment and inclusion of a control group. [31,36,39,40] Two of these studies utilized designs where facilities were randomly assigned to experimental conditions and included adequate sample sizes of over 200, [39,40] whereas two studies [31,36] included random assignment of participants to conditions, but with smaller sample sizes (N = 67 and N = 33, respectively).…”

The French National Alzheimer disease plan 2008–2012

“…For this goal we need to have training programs having demonstrated their efficacy and therefore we need to boost clinical research in this field. That was the aim of the TNM (Traitement Non Médicamenteux) which aimed to evaluate the effectiveness of a staff education intervention to manage behavioural disturbance in older people with a diagnosis of dementia (Deudon et al, 2009). After such demonstration and the present grant application of the Fédération de Coopération Scientifique, the major the major challenge of the French National plan for AD, is to promote the feasibility of applying the programme to all nursing homes in France.…”