International Psychogeriatrics

Review Article

Case conferences as interventions dealing with the challenging behavior of people with dementia in nursing homes: a systematic review

Sven Reuthera1a2 c1, Martin Nikolaus Dichtera1a2, Ines Buschera1, Horst Christian Vollmara1a3, Daniela Hollea1, Sabine Bartholomeyczika1a2 and Margareta Haleka1a2

a1 German Center for Neurodegenerative Diseases (DZNE), Witten, Germany

a2 School of Nursing Science, Witten/Herdecke University, Witten, Germany

a3 Institute of General Practice, Faculty of Health, Heinrich Heine University, Duesseldorf, Germany


Background: Challenging behaviors such as aggression, screaming, and apathy are often encountered when caring for people with dementia in nursing homes. In this context, a case conference is often recommended for healthcare professionals as an effective instrument to improve the quality of care. However, the subject case conference has not had great consideration in scientific literature. The aim of this review is to describe the effects of case conferences on people with dementia and challenging behavior and the staff in nursing homes.

Methods: A search of intervention studies in nursing homes in the German or English language was performed in the following databases: Medline, Cinahl, PsycINFO, Cochrane library, Embase, and Google Scholar. The selection and the methodological quality of the studies were assessed independently by two authors. The results were summarized and compared based on categories such as study quality or outcomes.

Results: Seven of 432 studies were included in the review. A total of four of seven studies showed a reduction in the challenging behavior of people with dementia, and five showed an influence on the competence, attitudes, and job satisfaction of the staff. However, due to the middle-range quality of several studies, the methodological heterogeneity and differences in the interventions, the results must be interpreted with caution.

Conclusions: In summary, little evidence exists for the positive effects of case conferences in the care of people with dementia. This review highlights the need for methodologically well-designed intervention studies to provide conclusive evidence of the effects of case conferences.

(Received February 06 2012)

(Reviewed May 20 2012)

(Revised July 05 2012)

(Accepted July 10 2012)

(Online publication August 15 2012)

Key words:

  • long-term care;
  • behavioral and psychological symptoms of dementia (BPSD);
  • psychosocial interventions;
  • nursing;
  • residential facilities


c1 Correspondence should be addressed to: Sven Reuther, MScN, German Center for Neurodegenerative Diseases (DZNE), Stockumer Str. 12, 58453 Witten, Germany. Phone: +49 2302 926-231; Fax: +49 2302 926-239. Email: