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- Title
Management of behavioural and psychological symptoms of dementia (BPSD): An integrative review.
- Authors
Sibley, Elyse; Mercer, Christine
- Abstract
Background: Behavioural and psychological symptoms of dementia (BPSD) describes any agitation, aggression or escalated behaviours in a person with dementia. Recommended best practice for managing challenging BPSD is the use of nonpharmacological interventions in the first instance. Antipsychotic PRN medication is not recommended as a first-line intervention, and yet it is often used in this way. Aim: In this study, we used an integrative review to investigate why it may be challenging for staff to use nonpharmacological interventions for managing BPSD, leading them to rely on antipsychotics. Methods: The review process was based on Whittemore and Knafl's (2005) steps for conducting an integrative review. Articles that studied the use of PRN antipsychotics, or non-pharmacological interventions, were accessed and analysed. Inclusion criteria were a focus on older adults, with a diagnosis of BPSD who were prescribed PRN anti-psychotic medication as well as non-pharmacological interventions and were hospitalised in aged residential care/acute settings. Excluded from the study were references to younger patients, those with dementia but not BPSD, and those living at home. Results: Three themes emerged from the review: Low staff-to-patient ratios increased instances of problems with BPSD; numbers of staff with specialised training were low; and there was a need to educate staff further about the manifestation of BPSD and the implementation of person-centred care plans. Overall, use of care plans, focused on the individual, reduced use of PRN antipsychotics. Conclusions: The management of BPSD is complicated by a mix of low staffing, and/or inadequate training opportunities, leading to increased risk for both the individual and possible staff burnout. The research has shown an increase in education/training reduces these risks when paired with implementation of nonpharmacological care plans.
- Subjects
DIAGNOSIS of dementia; TREATMENT of dementia; PSYCHOLOGICAL burnout; SYSTEMATIC reviews; ACQUISITION of data; BEHAVIOR disorders; HOSPITAL nursing staff; MEDICAL records; WORKING hours; PSYCHOLOGICAL stress; ANTIPSYCHOTIC agents; NURSE-patient ratio; OLD age
- Publication
Kaitiaki Nursing Research, 2023, Vol 14, Issue 1, p41
- ISSN
1179-772X
- Publication type
Article