Nonpharmacological Therapy for the Management of Neuropsychiatric Symptoms of Alzheimer's Disease: Linking Evidence to Practice

BackgroundBehavioral and psychiatric symptoms of dementia affect up to 90% of all patients at some point during their dementing illness. Today, many of these symptoms are treated with pharmacological therapy alone, incongruent with clinical recommendations. Barriers to the use of nonpharmacological interventions with dementia include a lack of education among caregivers on available options, shortage of time for implementation, lack of education on effects of nonpharmacological therapy, poor staff to resident ratios, and unmodifiable physical environments. AimsThe purpose of this paper is to explore current literature regarding the implementation of nonpharmacological therapy as an adjunct treatment to manage agitation in dementia, to identify practice discrepancies seen commonly among formal and informal caregivers, and to make recommendations for implementing evidence into practice. MethodsA systematic review of the literature published between 2009 and 2014 was conducted. Four databases were searched including CINAHL, Pubmed, the Cochrane Library, and PsycInfo. FindingsThe most prevalent and substantial conclusion among the 10 studies evaluated is that nonpharmacological therapy is safe and effective. Although not every study was able to show statistically significant outcomes when compared to controls, all studies demonstrated a positive trend toward decreasing agitation without any adverse side effects. Linking Evidence to ActionA multicomponent caregiver education program focused on evidence-based nonpharmacological strategies for addressing agitation in persons with Alzheimer's disease has the potential to decrease agitation, improve patient outcomes, and increase caregiver satisfaction.