US nurse researchers have developed a six-step approach to help manage behavioural symptoms in dementia patients, which they say can be used across all settings.
Behaviour changes are among the “most visible, disruptive and distressing symptoms” of dementia, note the researchers from Johns Hopkins University.
Symptoms such as confusion, repetitive questioning and combativeness to wandering, hallucinations and loss of inhibition have been a challenge to clinicians, they said, particularly as many drugs carry significant risks and have been found to be relatively ineffective.
But many symptoms can be managed well, without medications, if clinicians integrate behavioural management strategies into ongoing treatment and break daily activities into small, simple steps and to establish structured routines.
The researchers have outlined a six-step approach to help clinicians identify and effectively manage most behavioural symptoms of dementia:
- screen for behavioural symptoms early
- identify symptoms
- delineate the triggers and risk factors for the symptoms
- choose the proper interventions. For example, an individual with dementia might wake repeatedly each night, voicing fear of being alone in the dark, despite continuous calming efforts. An intervention might mean introducing a nightlight in the patient’s room
- evaluate the intervention to make sure that it is working
- follow the patient’s progress over time
Professor Laura Gitlin said: “This six-step process should be a routine part of regular health care for individuals with dementia.
“It should be undertaken in any clinical setting involved in caring for someone with dementia, including primary care and memory clinics, as well as in hospitals, assisted living and nursing facilities.”