Skip to main content
×
×
Home

Psychosocial interventions for dementia: from evidence to practice

  • Bhamini Patel, Mark Perera, Jill Pendleton, Anna Richman and Biswadeep Majumdar...
Summary

This article presents evidence for the efficacy of psychosocial interventions for people with dementia and their carers. The evidence base is not yet robust enough to clearly suggest which interventions are most suited for which environment. However, from our literature review there appears to be reason to use music therapy, aromatherapy, life story work, animal-assisted therapy and post-diagnosis/carer support work. We focus on both the traditional outcome measures of behavioural and psychological symptoms of dementia (BPSD) and the more difficult to measure, but equally important, person-centred outcomes of nonpharmacological interventions, as their properties are distinctly different from those of pharmacological agents.

Learning Objectives

  1. Be aware of the range of psychosocial interventions.
  2. Have a better understanding of the possible outcomes from given interventions.
  3. Be aware of the paradigm shift from managing BPSD to a person-centred approach that focuses on the patient's well-being and quality of life.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Psychosocial interventions for dementia: from evidence to practice
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Psychosocial interventions for dementia: from evidence to practice
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Psychosocial interventions for dementia: from evidence to practice
      Available formats
      ×
Copyright
Corresponding author
Dr Bhamini Patel, Waterloo Day Hospital, Park Road, Liverpool L22 3XR, UK. Email: Bhaminipatel@nhs.net
Footnotes
Hide All

Declaration of Interest

None.

Footnotes
References
Hide All
Aguirre, E, Woods, R, Spector, A et al (2013) Cognitive stimulation for dementia: a systematic review of the evidence of effectiveness from randomised controlled trials. Ageing Research Reviews, 12: 253–62.
Baher-Fuchs, A, Clare, L, Woods, B (2013) Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer's disease and vascular dementia. Cochrane Database of Systematic Reviews, 6: CD003260.
Baker, L, Frank, L, Foster-Schubert, K et al (2010) Effects of aerobic exercise on mild cognitive impairment. Archives of Neurology, 67: 71–9.
Banerjee, S (2009) The Use of Antipsychotic Medication for People with Dementia: Time for Action (A Report for the Minister of State for Care Services). Department of Health.
Barrick, A, Sloane, P, Williams, C et al (2010) Impact of ambient bright light on agitation in dementia. International Journal of Geriatric Psychiatry, 25: 1013–21.
Beard, RL (2012) Art therapies and dementia care: a systematic review. Dementia, 11: 633–56.
Bernabei, V, De Ronchi, D, La Ferla, T et al (2013) Animal-assisted interventions for elderly patients affected by dementia or psychiatric disorders: a review. Journal of Psychiatric Research, 47: 762–73.
Bicket, M, Samus, Q, McNabney, M et al (2010) The physical environment influences neuropsychiatry symptoms and other outcomes in assisted living residents. International Journal of Geriatric Psychiatry, 25: 1044–54.
Bowlby, J (1960) Attachment and Loss, Vol. 1. Attachment. Hogarth Press.
Brechin, D, Murphy, G, James, I et al (2013) Alternatives to Antipsychotic Medication: Psychological Approaches in Managing Psychological and Behavioural Distress in Dementia (Briefing Paper for the British Psychological Society). BPS.
Brodaty, H, Arasaratnam, C (2012) Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. American Journal of Psychiatry, 169: 946–53.
Brooker, D, Woolley, R, Lee, D (2007) Enriching opportunities for people living with dementia in nursing homes: an evaluation of a multi-level activity-based model of care. Aging and Mental Health, 11: 361–70.
Buchman, A, Boyle, P, Yu, L et al (2012) Total daily physical activity and the risk of Alzheimer's disease and cognitive decline in older adults. Neurology, 78: 1323–9.
Burns, A, Allen, H, Tomenson, B et al (2007) Bright light therapy for agitation in dementia: a randomized controlled trial. International Psychogeriatrics, 21: 711.
Clare, L, Woods, B (2003) Cognitive rehabilitation and cognitive training for early stage Alzheimer's disease and vascular dementia. Cochrane Database of Systematic Reviews, 4: CD003260.
Clare, L, Linden, D, Woods, RT et al (2010) Goal-oriented cognitive rehabilitation for people with early-stage Alzheimer disease: a single-blind randomized controlled trial of clinical efficacy. American Journal of Geriatric Psychiatry, 18: 928–39.
Cohen-Mansfield, J (1986) Agitated behaviors in the elderly. II. Preliminary results in the cognitively deteriorated. Journal of the American Geriatrics Society, 34: 722–7.
Davis, S, Byers, S, Nay, R et al (2009) Guiding design of dementia friendly environments in residential care settings: considering the living experiences. Dementia, 8: 185203.
Department of Health (2009) Living Well with Dementia: A National Dementia Strategy. Department of Health.
Douglas, S, James, I, Ballard, C (2004) Nonpharmacological interventions in dementia. Advances in Psychiatric Treatment, 10: 171–7.
Dowling, G, Hubbard, E, Mastick, J et al (2005) Effect of morning bright light treatment for rest-activity disruption in institutionalized patients with severe Alzheimer's disease. International Psychogeriatrics, 17: 221–36.
Dulicai, D, Berger, M (2005) Global dance/movement therapy growth and development. The Arts in Psychotherapy, 32: 205–16.
Ellingford, J, Mackenzie, L, Marsland, L (2007) Using dolls to alter behaviour in patients with dementia. Nursing Times, 103: 36–7.
Feil, N (1982) The Feil Method: How to Help Disoriented Old-Old. Feil Productions.
Feil, N (1993) The Validation Breakthrough: Simple Techniques for Communicating with People with ‘Alzheimer's-Type Dementia’. Health Promotion Press.
Figueiro, MG (2008) A proposed 24 h lighting scheme for older adults. Lighting Research and Technology, 40: 153–60.
Folstein, MF, Folstein, SE, McHugh, PR (1975) ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12: 189–98.
Forbes, D, Forbes, S, Morgan, D et al (2008) Physical activity programme for people with dementia. Cochrane Database of Systematic Reviews, 3: CD006489.
Forbes, D, Culum, I, Lischka, A et al (2009) Light therapy for managing cognitive, sleep, functional, behavioural or psychiatric disturbances in dementia. Cochrane Database of Systematic Reviews, 4: CD003946.
Fung, J, Tsang, H, Chung, R (2012) A systematic review of the use of aromatherapy in treatment of behavioral problems in dementia. Geriatrics and Gerontology International, 12: 372–82.
Gates, N, Sachdev, P, Fiatarone Singh, M et al (2011) Cognitive and memory training in adults at risk of dementia; a systematic review. BMC Geriatrics, 11: 55.
German Institute for Quality and Efficiency in Health Care (2009) Nichtmedikamentöse Behandlung der Alzheimer Demenz (IQWiG-Berichte Nr. 41) [Non-Pharmacological Treatment of Alzheimer's Dementia (IDWiG Reports no. 41)]. Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen.
Hanford, N, Figuero, M (2013) Light therapy and alzheimer's disease and related dementia: past, present and future. Journal of Alzheimer's Disease, 33: 913–22.
Heyn, P, Abreu, BC, Ottenbacher, KJ (2004) The effects of exercise training on elderly persons with cognitive impairment and dementia: a meta-analysis. Archives of Physical Medicine and Rehabilitation, 85: 1694–704.
James, I, Mackenzie, L, Mukaetova-Ladinska, E (2006) Doll use in care homes for people with dementia. International Journal of Geriatric Psychiatry, 21: 1093–8.
Kahn-Denis, K (1997) Art therapy with geriatric dementia clients. Art Therapy, 14: 194–9.
Killick, J, Allan, K (1999) The arts in dementia care: tapping a rich resource. Journal of Dementia Care, 7: 35–8.
Kitwood, T (1997) Dementia Reconsidered: The Person Comes First. Open University Press.
Kolanowski, A, Hill, N (2013) Community-based nonpharmacological interventions delivered by family caregivers reduce behavioural and psychological symptoms of dementia. Evidence Based Nursing, 16: 67–8.
Lautenschlager, N, Cox, K, Flicker, L (2008) Physical activity improves cognitive function in people with memory impairments. JAMA, 300: 1027–37.
Lawrence, V, Fossey, J, Ballard, C et al (2012) Improving quality of life for people with dementia in care homes: making psychosocial interventions work. British Journal of Psychiatry, 201: 344–51.
Lawton, M (1990) Environmental approaches to research and treatment of Alzheimer's disease. In Alzheimer's Disease Treatment and Family Stress: Direction for Research (eds Light, E, Lebowitz, BD) 340–62. Hemisphere Publishing.
Mackenzie, L, James, I, Morse, R et al (2006) A pilot study on the use of dolls for people with dementia. Age and Ageing, 35: 441–4
Mackenzie, L, Wood-Mitchell, A, James, I (2007) Guidelines on using dolls. Journal of Dementia Care, 15: 26.
Marim, C, Silva, V, Taminato, M et al (2013) Effectiveness of educational programs on reducing the burden of caregivers of elderly individuals with dementia: a systematic review. Revista Latino-Americana de Enfermagem, 21: 267–75.
McKeown, J, Clarke, A, Repper, J (2006) Life story work in health and social care: systematic literature review. Journal of Advanced Nursing, 55: 237–47.
Meissen, B (1993) Alzheimer's disease, the phenomenon of parent fixation and Bowlby's Attachment Theory. International Journal of Geriatric Psychiatry, 8: 147–53.
Moniz-Cook, E, Swift, K, James, I et al (2012) Functional analysis based interventions for challenging behaviour in dementia. Cochrane Database of Systematic Reviews, 2: CD006929.
Moos, I, Bjorn, A (2006) Use of the life story in the institutional care of people with dementia: a review of intervention studies. Ageing and Society, 26: 431–54.
Morgan, D, Stewart, N, D'arcy, K et al (2004) Evaluating rural nursing home environments: dementia special care units versus integrated facilities. Aging and Mental Health, 8: 256–65.
National Collaborating Centre for Mental Health (2007) Dementia: A NICE-SCIE Guideline on Supporting People with Dementia and their Carers in Health and Social Care. British Psychological Society and Gaskell.
National Institute for Health and Clinical Excellence (2008) Physical Activity and the Environment (NICE Public Health Guidance 8). NICE.
Neal, M, Barton Wright, P (2003) Validation therapy for dementia. Cochrane Database of Systematic Reviews, 3: CD001394.
Neal, M, Wright, PB (2009) Validation therapy for dementia (update). Cochrane Database of Systematic Reviews, 1: CD001394.
Olazarán, J1, Reisberg, B, Clare, L et al (2010) Nonpharmacological therapies in Alzheimer's disease: a systematic review of efficacy. Dementia and Geriatric Cognitive Disorders, 30: 161–78.
Oyebode, J, Clare, L (2008) Supporting Cognitive Abilities. Excellence in Dementia Care: Principles and Practice. Open University Press.
Parker, C, Barnes, S, McKee, K et al (2004) Quality of life and building design in residential and nursing homes for older people. Ageing and Society, 24: 941–62.
Perrin, T (1997) Occupational need in severe dementia: a descriptive study. Journal of Advanced Nursing, 25: 934–41.
Perrin, T, May, H (2000) Wellbeing and Dementia: An Occupational Approach for Therapists and Carers. Churchill Livingstone.
Rentz, CA (2002) Memories in the making: outcome-based evaluation of an art program for individuals with dementing illnesses. American Journal of Alzheimer's Disease and Other Dementias, 17: 175–81.
Rieckmann, N, Schwarzbach, C, Nocon, M et al (2009) Pflegerische Versorgungskonzepte für Personen mit Demenzerkrankungen (HTA-Bericht 80) [Concepts of Care for People with Dementia (HTA Report 80)]. Deutschen Institut für Medizinische Dokumentation und Information.
Robinson, L, Clare, , Evans, K (2005) Making sense of dementia and adjusting to loss: psychological reactions to a diagnosis of dementia in couples. Ageing and Mental Health, 9: 337–47.
Sanchez, A, Millan-Calenti, J, Lorenzo-Lopez, L et al (2013) Multisensory stimulation for people with dementia: a review of the literature. American Journal of Alzheimer's Disease and Other Dementias, 28: 714.
Schwarzbach, C, Förstl, H, Nocon, M et al (2012) Why is it so difficult to evaluate nursing interventions in dementia? Dementia and Geriatric Cognitive Disorders Extra, 2: 146–59.
Spector, A, Orrell, M, Davies, S et al (2000) Reality Orientation for dementia: a review of the evidence of effectiveness from randomised controlled trials. Gerontologist, 40: 206–12.
Stevenson, A, Thomson, J, Roth, H (2010) Dolls: handle with care. Journal of Dementia Care, 18: 16–7.
Thompson, R (2011) Using life story work to enhance care. Nursing Older People, 23: 1621.
Ueda, T, Suzukamo, Y, Sato, M et al (2013) Effects of music therapy on behavioral and psychological symptoms of dementia: a systematic review and meta-analysis. Ageing Research Reviews, 12: 628–41.
Verity, J (2006) Dolls in dementia care: bridging the divide. Journal of Dementia Care, 14: 25–7.
Vreugdenhil, A, Cannell, J, Davies, A et al (2012) A community-based exercise programme to improve functional ability in people with Alzheimer's disease: a randomized controlled trial. Scandinavian Journal of Caring Sciences, 26: 12–9.
Werezak, L, Morgan, D (2003) Creating a therapeutic psychosocial environment in dementia care. A preliminary framework. Journal of Gerontological Nursing, 29: 18.
Whitlatch CJ Feinberg, L, Tucke, S (2005) Measuring the values and preferences for everyday care of persons with cognitive impairment and their family caregivers. Gerontologist, 45: 370–80.
Winchester, J, Dick, MB, Gillen, D et al (2012) Walking stabilizes cognitive functioning in Alzheimer's disease (AD) across one year. Archives of Gerontology and Geriatrics, 56: 96103.
Woods, R, Bruce, E, Edwards, R et al (2012) REMCARE: reminiscence groups for people with dementia and their family caregivers – effectiveness and cost-effectiveness pragmatic multicentre randomised trial. Health Technology Assessment, 16: vxv, 1–116.
Zeisel, J, Silverstein, N, Hyde, J et al (2003) Environmental correlates to behavioral health outcomes in Alzheimer's special care units. Gerontologist, 43: 697711.
Zeisel, J (2009) I'm Still Here: A New Philosophy of Alzheimer's Care. Penguin Group.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
  • URL: /core/journals/bjpsych-advances
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Psychosocial interventions for dementia: from evidence to practice

  • Bhamini Patel, Mark Perera, Jill Pendleton, Anna Richman and Biswadeep Majumdar...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *