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Psychosocial interventions for dementia patients in long-term care

Published online by Cambridge University Press:  03 September 2010

Myrra Vernooij-Dassen*
Affiliation:
Radboud University Nijmegen Medical Centre, Kalorama Foundation, Nijmegen, The Netherlands
Emmelyne Vasse
Affiliation:
Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Sytse Zuidema
Affiliation:
Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Jiska Cohen-Mansfield
Affiliation:
Herczeg Institute on Aging and Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel and Department of Health Care Sciences, George Washington University Medical Center and School of Public Health, Washington, DC, U.S.A.
Wendy Moyle
Affiliation:
Research Centre for Clinical and Practice Innovation, Griffith University, Brisbane, Australia
*
Correspondence should be addressed to: Prof. Dr. M. Vernooij-Dassen, Kalorama Foundation and Radboud University Nijmegen Medical Centre, P.O. Box 9101, 114 IQ healthcare, 6500 HB Nijmegen, Geert Grooteplein 21, Nijmegen, The Netherlands. Phone: +31 24-3666265; Fax: +31 243540166. Email: m.vernooij-dassen@iq.umcn.nl.

Abstract

Background: Psychosocial interventions in long-term care have the potential to improve the quality of care and quality of life of persons with dementia. Our aim is to explore the evidence and consensus on psychosocial interventions for persons with dementia in long-term care.

Methods: This study comprises an appraisal of research reviews and of European, U.S. and Canadian dementia guidelines.

Results: Twenty-eight reviews related to long-term care psychosocial interventions were selected. Behavioral management techniques (such as behavior therapy), cognitive stimulation, and physical activities (such as walking) were shown positively to affect behavior or physical condition, or to reduce depression. There are many other promising interventions, but methodological weaknesses did not allow conclusions to be drawn. The consensus presented in the guidelines emphasized the importance of care tailored to the needs and capabilities of persons with dementia and consideration of the individual's life context.

Conclusions: Long-term care offers the possibility for planned care through individualized care plans, and consideration of the needs of persons with dementia and the individual life context. While using recommendations based on evidence and consensus is important to shape future long-term care, further well-designed research is needed on psychosocial interventions in long-term care to strengthen the evidence base for such care.

Type
Focus on mental health issues in long-term-care homes
Copyright
Copyright © International Psychogeriatric Association 2010

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References

AGS (2003). Guidelines abstracted from the American Academy of Neurology's Dementia Guidelines for early detection, diagnosis, and management of dementia. Journal of the American Geriatrics Society, 51, 869873.CrossRefGoogle Scholar
APA Work Group on Alzheimer's Disease and Other Dementias (2007). American Psychiatric Association Practice Guideline for the treatment of patients with Alzheimer's disease and other dementias. Second edition. American Journal of Psychiatry, 164 (Suppl.), 5556.Google Scholar
Ayalon, L., Gum, A. M., Feliciano, L. and Arean, P. A. (2006). Effectiveness of nonpharmacological interventions for the management of neuropsychiatric symptoms in patients with dementia: a systematic review. Archives Internal Medicine, 166, 21822188.CrossRefGoogle ScholarPubMed
Bartholomeyczik, S. et al. (2006). Rahmenempfehlungen zum Umgang mit herausforderndem Verhalten bei Menschen mit Demenz in der stationären Altenhilfe [Guidelines to support people with dementia and neuropsychiatric symptoms in institutional care]. Berlin: Bundesministerium für Gesundheit.Google Scholar
Brodaty, H., Green, A. and Koschera, A. (2003). Meta-analysis of psychosocial interventions for caregivers of people with dementia. Journal of the American Geriatrics Society, 51, 657664.CrossRefGoogle ScholarPubMed
Canadian Coalition for Seniors' Mental Health (CCSMH). (2006). National Guidelines for Seniors Mental Health’: The Assessment and Treatment of Mental Health Issues in Long-Term Care Home (Focus on Mood and Behavior Symptoms). Available at www.ccsmh.can.Google Scholar
Chenoweth, L. et al. (2009). Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lancet Neurolology, 8, 317325.CrossRefGoogle ScholarPubMed
Chung, J. C. C., Lai, C. K. Y., Chung, P. M. and French, H. P. (2002). Snoezelen for dementia. Cochrane Database of Systematic Reviews, 4, CD003152.Google Scholar
Chung, J. C. C. and Lai, C. K. Y. (2008). Snoezelen for dementia (update). Cochrane Database of Systematic Reviews, Reviews 2002, Issue 4. Art. No.: CD003152. doi:10.1002/14651858.CD003152.CrossRefGoogle Scholar
Clare, L., Woods, R. T., Moniz Cook, E. D., Orrell, M. and Spector, A. (2003). Cognitive rehabilitation and cognitive training for early-stage Alzheimer's disease and vascular dementia. Cochrane Database of Systematic Reviews, 4, CD003260.Google Scholar
Cohen-Mansfield, J. (2001). Nonpharmacological interventions for inappropriate behaviors in dementia: a review, summary, and critique. American Journal of Geriatric Psychiatry, 9, 361381.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., Libin, A. and Marx, M. S. (2007). Non-pharmacological treatment of agitation: a controlled trial of systematic individualized intervention. Journals of Gerontology: Medical Sciences, 62, 908916.Google Scholar
de Klerk, M. M. Y. (2001). Report on the Elderly 2001. The Hague: Netherlands Institute for Social Research.Google Scholar
Heyn, P., Abreu, B. C. and Ottenbacher, K. J. (2004). The effects of exercise training on elderly persons with cognitive impairment and dementia: a meta-analysis. Archives of Physical Medicine and Rehabilitation, 85, 16941704.CrossRefGoogle ScholarPubMed
Holt, F. E., Birks, T. P. H, Thorgrimsen, L. M., Spector, A. E., Wiles, A. and Orrell, M. (2003). Aroma therapy for dementia. Cochrane Database of Systematic Reviews 2003, 3, CD003150. (updated in 2008).Google Scholar
Kuske, B., Hanns, S., Luck, T., Angermeyer, M. C., Behrens, J. and Riedel-Heller, S. G. (2007). Nursing home staff training in dementia care: a systematic review of evaluated programs. International Psychogeriatrics, 19, 818841.CrossRefGoogle Scholar
Levy-Storms, L. (2008). Therapeutic communication training in long-term care institutions: recommendations for future research. Patient Education and Counseling, 73, 821.CrossRefGoogle ScholarPubMed
Livingston, G., Johnston, K., Katona, C. and Lyketsos, C. G. (2005). Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. American Journal of Psychiatry, 162, 19962021.CrossRefGoogle Scholar
Logsdon, R.G., McCurry, S. M. and Teri, L. (2007). Evidence-based psychological treatments for disruptive behaviors in individuals with dementia. Psychology and Aging, 22, 2836.CrossRefGoogle ScholarPubMed
NICE/SCIE (2006). Dementia: Supporting People with Dementia and Their Carers in Health and Social Care. London: National Institute for Clinical Excellence and Social Care (NICE/SCIE).Google Scholar
Neal, M. and Barton Wright, P. (2003). Validation therapy for dementia. Cochrane Database of Systematic Reviews, 3, CD001394.Google Scholar
Netherlands Institute for Health Services Research (NIVEL); Verpleeghuis Waerthove (2004). Het begeleiden van mensen met dementie die apathisch zijn. Richtlijn voor verzorgenden. [Supporting Apathetic People with Dementia. Guidelines for Nursing Staff]. Utrecht: NIVEL.Google Scholar
O'Connor, D. W., Ames, D., Gardner, B. and King, M. (2009a). Psychosocial treatments of psychological symptoms in dementia: a systematic review of reports meeting quality standards. International Psychogeriatrics, 21, 241251.CrossRefGoogle ScholarPubMed
O'Connor, D. W., Ames, D., Gardner, B. and King, M. (2009b). Psychosocial treatments of behavior symptoms in dementia: a systematic review of reports meeting quality standards. International Psychogeriatrics, 21, 225240.CrossRefGoogle ScholarPubMed
Price, J. D., Hermans, D. G. and Grimley Evans, J. (2000). Subjective barriers to prevent wandering of cognitively impaired people. Cochrane Database of Systematic Reviews, 4, CD001932. Update 2009.Google Scholar
Robinson, L., Hutchings, D., Corner, L., Beyer, F., Dickinson, H. and Vanoli, A. (2006). A systematic literature review of the effectiveness of non-pharmacological interventions to prevent wandering in dementia and evaluation of the ethical implications and acceptability of their use. Health Technology Assessment, 10, ix108.CrossRefGoogle ScholarPubMed
Robinson, L., Hutchings, D., Dickinson, H. O., Corner, L., Beyer, F. and Finch, T. (2007). Effectiveness and acceptability of non-pharmacological interventions to reduce wandering in dementia: a systematic review. International Journal of Geriatric Psychiatry, 22, 922.CrossRefGoogle ScholarPubMed
Scottish Intercollegiate Guideline Network (SIGN). (2006). Management of Patients with Dementia: A National Clinical Guideline. Edinburgh: Scottish Intercollegiate Guideline Network.Google Scholar
Spira, A. P. and Edelstein, B. A. (2006). Behavioral interventions for agitation in older adults with dementia: an evaluative review. International Psychogeriatrics, 18, 195225.CrossRefGoogle ScholarPubMed
Teri, L., McKenzie, G. and LaFazia, D. (2005). Psychosocial treatment of depression in older adults with dementia. Clinical Psychology: Science and Practice, 12, 303316.Google Scholar
Vasse, E., Vernooij-Dassen, M., Cantegreil, I., Franco, M., Woods, B. and Moniz-Cook, E. D. (2008). European guidelines on psychosocial interventions. In Georges, J. (ed.), Dementia in Europe Yearbook 2008: Report on European Collaboration on Dementia (pp. 88112), Luxembourg: Alzheimer Europe.Google Scholar
Vasse, E., Vernooij-Dassen, M., Spijker, A., Olde-Rikkert, M. and Koopmans, R. (2010). A systematic review of communication strategies for people with dementia in residential and nursing homes. International Psychogeriatrics, 22, 189200.CrossRefGoogle ScholarPubMed
Verkaik, R, van Weert, J. C. and Francke, A. L. (2005). The effects of psychosocial methods on depressed, aggressive and apathetic behaviors of people with dementia: a systematic review. International Journal of Geriatric Psychiatry, 20, 301314.CrossRefGoogle ScholarPubMed
Vernooij-Dassen, M. J., Moniz-Cook, E. M., Woods, B., de Lepeleire, J., Leuschner, A. and Zanetti, O. (2005). Factors affecting timely recognition and diagnosis of dementia across Europe: from awareness to stigma. International Journal of Geriatric Psychiatry, 20, 377386.CrossRefGoogle ScholarPubMed
Viggo Hansen, N., Jørgensen, T. and Ørtenblad, L. (2006). Massage and touch for dementia. Cochrane Database of Systematic Reviews, 4, CD004989.Google Scholar
Vink, A. C., Birks, J. S., Bruinsma, M. S. and Scholten, R. J. (2004). Music therapy for people with dementia. Cochrane Database of Systematic Reviews, 3, CD003477.Google Scholar
von Gunten, A., Alnawaqil, A. M., Abderhalden, C., Needham, I. and Schupbach, B. (2008). Vocally disruptive behavior in the elderly: a systematic literature review. International Psychogeriatrics, 20, 653672.CrossRefGoogle Scholar
Woods, B., Spector, A., Jones, C., Orrell, M. and Davies, S. (2005). Reminiscence therapy for dementia (Review). Cochrane Database of Systematic Reviews, 18, CD001120.Google Scholar
Ypma-Bakker, M. E. M. et al. (2002). Richtlijn probleemgedrag [Guideline Problematic Behavior] (updated October 2008). Utrecht: Dutch Society for Nursing Mome Physicians (NVVA).Google Scholar