Reduction of aggressive behavior and effects on improved wellbeing of health care workers and people with dementia: A review of reviews

Violence and aggressive behavior are part of behavioral and psychological symptoms of dementia (BPSD). Therefore, reducing BPSD might have positive effects on the wellbeing of older adults and direct care workers (DCW). This scoping review of reviews investigates to what extent interventions targeting BPSD integrate the 'work environment perspective' and the 'care perspective'. PubMed, Web of Science, and PsycINFO were searched for studies published from 2008 to 2019. Reviews were included if they assessed non-pharmacological interventions to reduce BPSD and included outcome measures on BPSD of the older adults and/or on the health/ wellbeing of DCW. We identified eighteen reviews 1) eleven reviews focused on changes in the care approach 2) six reviews covered interventions offering a specific activity/therapy and 3) two reviews looked at mixed approaches. Only six reviews had outcome measures on DCW. The six reviews found mixed results regarding the effect on DCW. More research combining the focus on work environment and eldercare treatment is needed to clarify if, and to what extent, the two aims of better care of older adults and a better work environment for DCW can influence each other positively. Based on the results, we present suggestions for how to advance this area of research.