scholarly journals Nonpharmacological Management of Behavioral and Psychological Symptoms of Dementia: What Works, in What Circumstances, and Why?

2017 ◽  
Vol 1 (3) ◽  
Author(s):  
Sienna Caspar ◽  
Erin D Davis ◽  
Aimee Douziech ◽  
David R Scott
Keyword(s):  
Psychological Symptoms ◽  
Empirical Studies ◽  
Realist Review ◽  
Care Providers ◽  
What Works ◽  
The Social ◽  
Noncognitive Symptoms ◽  
Training And Support ◽  
Behavioral And Psychological Symptoms ◽  
Partial Success

Abstract Objective Behavioral and psychological symptoms of dementia (BPSD) refer to the often distressing, noncognitive symptoms of dementia. BPSD appear in up to 90% of persons with dementia and can cause serious complications. Reducing the use of antipsychotic medications to treat BPSD is an international priority. This review addresses the following questions: What nonpharmacological interventions work to manage BPSD? And, in what circumstances do they work and why? Method A realist review was conducted to identify and explain the interactions among context, mechanism, and outcome. We searched electronic databases for empirical studies that reported a formal evaluation of nonpharmacological interventions to decrease BPSD. Results Seventy-four articles met the inclusion criteria. Three mechanisms emerged as necessary for sustained effective outcomes: the caring environment, care skill development and maintenance, and individualization of care. We offer hypotheses about how different contexts account for the success, failure, or partial success of these mechanisms within the interventions. Discussion Nonpharmacological interventions for BPSD should include consideration of both the physical and the social environment, ongoing education/training and support for care providers, and individualized approaches that promote self-determination and continued opportunities for meaning and purpose for persons with dementia.

Impact of Personality on Behavioral and Psychological Symptoms of Dementia

2000 ◽  
Vol 12 (S1) ◽  
pp. 107-109 ◽  
Author(s):  
Wolfgang Meins
Keyword(s):  
Disease Duration ◽  
Psychological Symptoms ◽  
Cognitive Symptoms ◽  
Premorbid Personality ◽  
Age Related ◽  
Noncognitive Symptoms ◽  
Related Stress ◽  
Severity Of Dementia ◽  
Social Causes ◽  
Behavioral And Psychological Symptoms

Compared with the rather uniform cognitive syndrome in Alzheimer's disease (AD), behavioral and psychological symptoms of dementia (BPSD) are considerably more heterogeneous in terms of incidence, prevalence, and association with disease duration and severity of dementia (Hope et al., 1999). The neurobiologic basis of AD is obviously less of a determinant of noncognitive symptoms than of cognitive symptoms. Therefore, the possible psychological and social causes of BPSD, such as premorbid personality, should be considered. Underlying personality traits not only shape a person's response to normal aging, but also set the stage for a range of responses to age-related stress and brain disease (Agronin, 1998).

The Pharmacological Approach of Behavioral Disturbances in Dementia

2004 ◽  
Vol 17 (2) ◽  
pp. 129-132 ◽  
Author(s):  
Robert L. Maher
Keyword(s):  
Caregiver Burden ◽  
Side Effect ◽  
Response Rate ◽  
Psychological Symptoms ◽  
Verbal Aggression ◽  
Behavioral Disturbances ◽  
Major Drawback ◽  
Inappropriate Behaviors ◽  
Noncognitive Symptoms ◽  
Behavioral And Psychological Symptoms

Behavioral and psychological symptoms in dementia (BPSD) are often overlooked due to the main focus of treating or preventing cognitive decline symptoms. Almost two-thirds of patients with dementia will develop some type of noncognitive symptoms that include symptoms such as wandering, agitation, sexually inappropriate behaviors, physical and verbal aggression, uncooperativeness, and “sun-downing.” Psychological symptoms include depression, anxiety, delusions, hallucinations, and suspiciousness/paranoia. Worsening of these symptoms can lead to caregiver burden and is one of the major reasons for patients with dementia to be institutionalized. A major drawback of treating these symptoms pharmacologically is that the response rate is low with the current available therapies such as antipsychotics, anxiolytics, and antidepressants. In addition, all of these therapeutic classes have drawbacks due to side effect profiles. This article provides an overview of the current recommendations for pharmacological approaches for the treatment of behavioral and psychological symptoms of dementia.

scholarly journals Modifiable Risk Factors of Behavioral and Psychological Symptoms in People with Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 648-649
Author(s):  
Shinae Seo ◽  
Meghan Mattos
Keyword(s):  
Risk Factors ◽  
Psychological Symptoms ◽  
Community Dwelling ◽  
Modifiable Risk Factors ◽  
Care Providers ◽  
Dyadic Relationship ◽  
People With Dementia ◽  
The Individual ◽  
Behavioral And Psychological Symptoms

Abstract Over ninety percent of people with dementia (PWD) experience behavioral and psychological symptoms, known to increase burden on care providers and healthcare systems. The purpose of this integrative review was to examine the modifiable risk factors of behavioral and psychological symptoms of dementia (BPSD) at the individual, caregiver, and environmental levels. An electronic database search was performed using PubMed, CINAHL[EBSCO], Web of Science, and PsycINFO from 2010-2020. Search terms included “dementia” AND (“Behavioral” OR “Behavioural” OR “Psychological” OR “Neuropsychiatric”) AND “symptoms” AND (“Independent Living” OR “Community Dwelling” OR “Community Living” OR “Living at Home” OR “Ageing in Place.” The search yielded 1,121 articles, and 14 articles were included in this review. Among the 14 articles, there were 11 modifiable risk factors presented across the individual, caregiver, and environmental levels. Individual-level factors included the presence of affective disorder, low quality of life, and leisure dysfunction. The modifiable caregiver-level factors included relationship with PWD, frequency of contact, caregiver burden, distress, frustration level, caregiver as a resource for PWD, and quality of dyadic relationship. One environmental factor, the presence of pandemic disease (e.g., COVID 19), was identified. This review presents the modifiable factors that contribute to the varied symptoms and multi domains of BPSD. Further research is necessary to determine whether, and to what degree, interventions targeting individual, caregiver, or environmental risk factors may reduce BPSD for PWD, caregivers, and providers within the community setting.

The Impact of COVID-19 and Associated Restrictions on Physical Activity Among Assisted Living Residents

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 419-419
Author(s):  
Barbara Resnick ◽  
Rachel McPherson ◽  
Elizabeth Galik
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Health Care Providers ◽  
Assisted Living ◽  
Psychological Symptoms ◽  
Descriptive Study ◽  
Care Providers ◽  
The Impact ◽  
Behavioral And Psychological Symptoms ◽  
Implementation Trial

Abstract COVID-19 and associated restrictions significantly impacted residents in assisted living (AL) communities. This was a descriptive study of 35 AL communities that were participating in an implementation trial of Function Focused Care for Assisted Living Residents with Dementia during the COVID-19 pandemic. Within twelve months of the COVID-19 pandemic, 18% of the AL communities had at least one resident who was positive for COVID-19. Almost half of the ALs allowed health care providers into the setting. All of the ALs facilitated family visits outside and by telephone and technology, but only 11% allowed visitors inside the community. Over 50% stopped using recreational supplies to encourage physical activity and 28% reported that residents experienced more behavioral and psychological symptoms of dementia. Restrictions designed to prevent the spread of COVID-19 may have negatively impacted resident behavior and the AL staff’s engagement of residents in physical and recreational activities during the pandemic.

scholarly journals A realist review and collaborative development of what works in the social prescribing process

The Lancet ◽  
2017 ◽  
Vol 390 ◽  
pp. S62 ◽  
Author(s):  
Rebecca Lovell ◽  
Kerryn Husk ◽  
Kelly Blockley ◽  
Alison Bethel ◽  
Dan Bloomfield ◽  
...  
Keyword(s):  
Realist Review ◽  
Collaborative Development ◽  
Social Prescribing ◽  
What Works ◽  
The Social

What Are the Necessary Characteristics of a Behavioral and Psychological Symptoms of Dementia Rating Scale?

2000 ◽  
Vol 12 (S1) ◽  
pp. 205-209 ◽  
Author(s):  
Ajit Shah
Keyword(s):  
Rating Scale ◽  
Psychological Symptoms ◽  
Consensus Conference ◽  
Measurement Instruments ◽  
Personality Changes ◽  
Diagnosis Of Dementia ◽  
Noncognitive Symptoms ◽  
Study Designs ◽  
Behavioral And Psychological Symptoms ◽  
Collection Methods

Dementia encompasses both cognitive and noncognitive domains. Noncognitive symptoms include disorders of behavior, personality, mood, thought content, and perception and impaired functional ability. Behavioral, personality, mood, and thought content disorders have been labeled behavioral and psychological symptoms of dementia (BPSD) following a previous International Psychogeriatric Association consensus conference. Traditionally, BPSD have been poorly studied for several reasons, including the lack of importance attached to cognition in the diagnosis of dementia, the assumption that BPSD are secondary to cognitive and personality changes, the difficulty of accurately defining BPSD, and the paucity of standardized instruments to measure BPSD. Historically, all BPSD tended to be studied together under one broad umbrella and thus older data on individual BPSD are limited. Differing definitions, patient populations, study designs, data collection methods, measurement instruments, and methodologic issues influence the prevalence of the various BPSD reported in different studies, making comparisons between studies difficult.

Fluid Multilingual Practices among Youth in Cameroon and Mozambique

2020 ◽  
Author(s):  
Torun Reite ◽  
Francis Badiang Oloko ◽  
Manuel Armando Guissemo
Keyword(s):  
Knowledge Production ◽  
Urban Youth ◽  
Social Space ◽  
Empirical Studies ◽  
Theoretical Discussion ◽  
The South ◽  
African Cities ◽  
Social Lives ◽  
The Social

Inspired by recent epistemological and ontological debates aimed at unsettling and reshaping conceptions of language, this essay discusses how mainstream sociolinguistics offers notions meaningful for studying contexts of the South. Based on empirical studies of youth in two African cities, Yaoundé in Cameroon and Maputo in Mozambique, the essay engages with “fluid modernity” and “enregisterment” to unravel the role that fluid multilingual practices play in the social lives of urban youth. The empirically grounded theoretical discussion shows how recent epistemologies and ontologies offer inroads to more pluriversal knowledge production. The essay foregrounds: i) the role of language in the sociopolitical battles of control over resources, and ii) speakers’ reflexivity and metapragmatic awareness of register formations of fluid multilingual practices. Moreover, it shows how bundles of localized meanings construct belongings and counterhegemonic discourses, as well as demonstrating speakers’ differential valuations and perceptions of boundaries and transgressions across social space.

scholarly journals Upskilling health and care workers with augmented and virtual reality: protocol for a realist review to develop an evidence-informed programme theory

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e050033
Author(s):  
Norina Gasteiger ◽  
Sabine N van der Veer ◽  
Paul Wilson ◽  
Dawn Dowding
Keyword(s):  
Virtual Reality ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Realist Review ◽  
Relevant Information ◽  
Care Providers ◽  
Programme Theory ◽  
Clinical Educators ◽  
Continued Learning ◽  
Search Quality

IntroductionAugmented reality (AR) and virtual reality (VR) are increasingly used to upskill health and care providers, including in surgical, nursing and acute care settings. Many studies have used AR/VR to deliver training, providing mixed evidence on their effectiveness and limited evidence regarding contextual factors that influence effectiveness and implementation. This review will develop, test and refine an evidence-informed programme theory on what facilitates or constrains the implementation of AR or VR programmes in health and care settings and understand how, for whom and to what extent they ‘work’.Methods and analysisThis realist review adheres to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) standards and will be conducted in three steps: theory elicitation, theory testing and theory refinement. First, a search will identify practitioner, academic and learning and technology adoption theories from databases (MEDLINE, Scopus, CINAHL, Embase, Education Resources Information Center, PsycINFO and Web of Science), practitioner journals, snowballing and grey literature. Information regarding contexts, mechanisms and outcomes will be extracted. A narrative synthesis will determine overlapping configurations and form an initial theory. Second, the theory will be tested using empirical evidence located from the above databases and identified from the first search. Quality will be assessed using the Mixed Methods Appraisal Tool (MMAT), and relevant information will be extracted into a coding sheet. Third, the extracted information will be compared with the initial programme theory, with differences helping to make refinements. Findings will be presented as a narrative summary, and the MMAT will determine our confidence in each configuration.Ethics and disseminationEthics approval is not required. This review will develop an evidence-informed programme theory. The results will inform and support AR/VR interventions from clinical educators, healthcare providers and software developers. Upskilling through AR/VR learning interventions may improve quality of care and promote evidence-based practice and continued learning. Findings will be disseminated through conference presentations and peer-reviewed journal articles.

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