Nonpharmacological Management of Agitated Behaviours Associated with Dementia

Dorothy A Forbes, RN, PhD; Shelley Peacock, RN, MN; Debra Morgan, RN, PhD

Disclosures

Geriatrics and Aging. 2005;8(4):26-30. 

In This Article

Abstract and Introduction

Strategies such as simulated presence therapy, pet therapy, light therapy, validation therapy, music, massage, therapeutic touch, aromatherapy, and multisensory stimulation have shown promising results in decreasing physical aggression, physical nonaggression, verbal aggression, and verbal nonaggression in older adults with dementia. Further research is needed to identify which strategies are most effective in managing symptoms of agitation associated with the different types of dementia and at different levels of cognitive impairment.

Eight percent of Canadians 65 years of age and older and 35% of those over the age of 85 have Alzheimer's disease and related dementias (ADRD). The average duration of dementia is 6.7 years for women and 4.6 years for men. Half of those with ADRD live in the community with a spouse, other family members, or friends, while the other half are cared for in institutions.[1] Behavioural disturbances are very common and increase distress for those with ADRD, increase the strain for informal caregivers (often resulting in the need for institutional care), and are potentially dangerous for other residents and staff. The most challenging of the behavioural disturbances is agitation, which encompasses four domains ( Table 1 ).[2]

Nonpharmacological approaches have several advantages. They address the psychosocial and/or environmental reason(s) for the agitation, and compared to pharmaceutical interventions they avoid potential side effects, drug-drug interactions, and masking of behaviour that may serve as a signal for a need.[2] The purpose of this review is, therefore, to assess and summarize research evidence on the efficacy of nonpharmacological strategies in managing agitated behaviour associated with ADRD.

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