Tailored Activities to Manage Neuropsychiatric Behaviors in Persons With Dementia and Reduce Caregiver Burden: A Randomized Pilot Study

Gitlin, Laura N.; Winter, Lieven De; Burke, Jeremy; Chernett, Nancy L.; Dennis, Marie P.; Hauck, Walter W.

doi:10.1097/01.jgp.0000300629.35408.94

Cited by 276 publications

(185 citation statements)

References 39 publications

(10 reference statements)

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“…Four of these studies were effective in reducing a variety of behaviors of concern (Belle et al, 2006;Gitlin et al, 2008;Nobili et al, 2004;Teri et al, 2005), whereas the remaining studies found a positive effect only for depressive symptoms in the person with dementia (Graff et al, 2007;Marriott et al, 2000;McCurry et al, 2005;Teri et al, 1997).…”

Section: Resultsmentioning

confidence: 93%

“…Eight studies reported an improvement in frequency, severity, or presence of behaviors of concern and psychological symptoms of dementia (Belle et al, 2006;Gitlin et al, 2008;Graff et al, 2007;Marriott et al, 2000;McCurry et al, 2005;Nobili et al, 2004;Teri et al, 1997;Teri et al, 2005) (Refer to Table 1). Four of these studies were effective in reducing a variety of behaviors of concern (Belle et al, 2006;Gitlin et al, 2008;Nobili et al, 2004;Teri et al, 2005), whereas the remaining studies found a positive effect only for depressive symptoms in the person with dementia (Graff et al, 2007;Marriott et al, 2000;McCurry et al, 2005;Teri et al, 1997).…”

Section: Resultsmentioning

confidence: 96%

“…Five of the studies provided interventions that addressed both the caregiver and the person with dementia (Gitlin et al, 2008;Graff et al, 2007;McCurry et al, 2005;Nobili et al, 2004;Teri et al, 1997), whereas the remaining three studies only involved the caregiver in the intervention (Belle et al, 2006;Marriott et al, 2000;Teri et al, 2005). Although the characteristics of studies varied, there were commonalities in the dose and components of effective interventions which can guide occupational therapists in their own clinical practice; intervention details are summarized below (Table 1).…”

Section: Resultsmentioning

confidence: 97%

“…One study intervention involved an assessment followed by two home visits: one from an occupational therapist and another from a psychologist (Nobili et al, 2004). The remaining interventions comprised six , eight (Gitlin et al, 2008;Teri et al, 2005), nine (Teri et al, 1997), 10 (Graff et al, 2007), 14 (Marriott et al, 2000), or 17 consultations (Belle et al, 2006). Interventions were conducted during home visits, telephone calls, or via a combination of home visits and phone calls.…”

Section: Dosementioning

confidence: 99%

“…Two of the interventions were delivered exclusively by an occupational therapist (Gitlin et al, 2008;Graff et al, 2007). An additional two of the interventions were provided by an occupational therapist in conjunction with another health professional (psychologist or nurse) or were developed by a team of people including occupational therapists (Belle et al, 2006;Nobili et al, 2004).…”

Section: Health Professional Providing the Interventionmentioning

confidence: 99%

See 4 more Smart Citations

Unpacking the Evidence: Interventions for Reducing Behavioral and Psychological Symptoms in People with Dementia

Laver

Clemson

Bennett

et al. 2014

Physical & Occupational Therapy In Geriatrics

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Aims: Behaviors of concern and psychological symptoms such as depression, apathy, agitation, wandering, and resistance to care are common in people with dementia and can be challenging for the caregiver to manage. This narrative review summarizes details of interventions found to be effective in reducing behaviors of concern and psychological symptoms. Methods: This review is based on an existing metaanalysis. The published meta-analysis included a large number of studies which ranged in efficacy. Studies were only included in this review if a moderate or large positive effect was found (Cohen's d ≥ 0.40). Information regarding the main aims of the intervention, dose, type of health professional providing the intervention, and the components of the intervention program were extracted. Results: Interventions with a positive effect contained multiple components including caregiver education, skills training, and engagement in meaningful occupations. Several of the interventions were delivered by an occupational therapist or were developed with extensive input from occupational therapists. Conclusion: This paper provides a description of effective interventions and can be utilized to guide the implementation of evidence-based practice in dementia care.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 97%

Section: Dosementioning

confidence: 99%

Section: Health Professional Providing the Interventionmentioning

confidence: 99%

See 3 more Smart Citations

Unpacking the Evidence: Interventions for Reducing Behavioral and Psychological Symptoms in People with Dementia

Laver

Clemson

Bennett

et al. 2014

Physical & Occupational Therapy In Geriatrics

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A Biobehavioral Home-Based Intervention and the Well-being of Patients With Dementia and Their Caregivers

Gitlin¹,

Winter²,

Dennis³

et al. 2010

JAMA

Self Cite

301

342

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Nonpharmacologic Management of Behavioral Symptoms in Dementia

Gitlin

Kales

Lyketsos

2012

JAMA

Self Cite

411

233

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Mr P is a 93-year-old bachelor who has lived in the United States since emigrating from Mexico at age 8. He began to have memory problems 13 years ago such as forgetting why he walked into a room or whether he had taken his medications. Mr P sought treatment in 2004 and scored 29 of 30 points on the Mini-Mental State Examination (MMSE; normal cognition score Ͼ24). His memory impairment, coupled with results from brain computed tomography showing white matter changes and bilateral and frontotemporal atrophy, led to diagnosis of mild cognitive impairment due to brain vascular disease. By 2010, Mr P's score had declined by 8 points (MMSE, 21/30) and his course of illness was considered consistent with mild progressive dementia. Mr P lives with Mr C, a cousin who is also his primary caregiver. Mr P has no children and all other family lives in Mexico. His caregiver is employed full time, which requires that Mr P stay at home alone. Mr P relies on his caregiver to organize and administer his 13 medications and to perform instrumental activities such as shopping and cooking. He dresses and bathes independently.Mr P maintained a positive mood as his disease progressed. He lacked insight into his memory problems. Neuropsychological testing revealed major impairments in executive function, verbal and spatial memory, wordfinding ability, and recall. His other diagnoses included hypertension, type 2 diabetes mellitus, lower extremity peripheral neuropathy, and coronary artery disease. Mr P's dementia progressed, he napped excessively during the day, experienced nighttime restlessness, and frequently awakened Mr C. Additionally, he withdrew from gardening and other previously enjoyed activities and reported feelings of insecurity and loneliness.CME available online at www.jamaarchivescme.com and questions on p 2041.

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Tailored Activities to Manage Neuropsychiatric Behaviors in Persons With Dementia and Reduce Caregiver Burden: A Randomized Pilot Study

Cited by 276 publications

References 39 publications

Unpacking the Evidence: Interventions for Reducing Behavioral and Psychological Symptoms in People with Dementia

Unpacking the Evidence: Interventions for Reducing Behavioral and Psychological Symptoms in People with Dementia

A Biobehavioral Home-Based Intervention and the Well-being of Patients With Dementia and Their Caregivers

Nonpharmacologic Management of Behavioral Symptoms in Dementia

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