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

Abstract

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.

The Spiritual Needs of Community‐Dwelling Older People Living With Early‐Stage Dementia—A Qualitative Study

“…The reaction of family members towards the signs and symptoms of dementia may influence older people’ coping strategies, such as using silence to face the conflicts between caregivers and themselves. Similar comments were also found in another study (Laver, Clemson, Bennett, Lannin, & Brodaty, ). Healthcare providers need to understand family relationships when they take care of older people with dementia at home.…”

Managing behavioural and psychological symptoms in community dwelling older people with dementia: 1. A systematic review of the effectiveness of interventions

“…It complements other overviews that emerged during the course of our study (e.g. Laver, Clemson, Bennett, Lannain, & Brodaty, 2014). Our review adds to knowledge with its synthesis of evidence on a broad group of interventions.…”

Are there missed opportunities for occupational therapy for people with dementia? An audit of practice in Australia

“…Current evidence supports longer term multicomponent occupational therapy interventions with one review (Laver, Clemson, Bennett, Lannin & Brodaty, ) showing effective interventions to reduce the behavioural symptoms of dementia provided an average of eight visits (range 3–17). Box 1 includes examples of such occupational therapy intervention programs found to be effective with community dwelling people with dementia.…”