PMID- 27543054
OWN - NLM
STAT- MEDLINE
DCOM- 20171120
LR  - 20181202
IS  - 1468-2834 (Electronic)
IS  - 0002-0729 (Linking)
VI  - 45
IP  - 6
DP  - 2016 Nov
TI  - The use of non-pharmacological interventions for dementia behaviours in care 
      homes: findings from four in-depth, ethnographic case studies.
PG  - 856-863
AB  - BACKGROUND: antipsychotic medications have been used to manage behavioural and 
      psychological symptoms of dementia (BPSD). Due to the potential risks associated 
      with these medications for people with dementia, non-pharmacological 
      interventions (NPIs) have been recommended as safer alternatives. However, it is 
      unknown if, or how, these interventions are used in care homes to help people 
      experiencing BPSD. AIM: to explore the use of NPIs in care homes to manage BPSD. 
      METHODS: In-depth, ethnographic case studies were conducted in four care homes; 
      in total, they included interviews with 40 care-home staff and 384 hours of 
      participant observations. FINDINGS: NPIs, some of which are the focus of efficacy 
      research, were used in care homes but predominantly as activities to improve the 
      quality of life of all residents and not identified by staff as meeting 
      individual needs in order to prevent or manage specific behaviours. Socially 
      relevant activities such as offering a cup of tea were used to address behaviours 
      in the moment. Residents with high levels of need experienced barriers to 
      inclusion in the activities. CONCLUSIONS: there is a gap between rhetoric and 
      practice with most NPIs in care homes used as social activities rather than as 
      targeted interventions. If NPIs are to become viable alternatives to 
      antipsychotic medications in care homes, further work is needed to embed them 
      into usual care practices and routines. Training for care-home staff could also 
      enable residents with high needs to gain better access to suitable activities.
CI  - (c) The Author 2016. Published by Oxford University Press on behalf of the British 
      Geriatrics Society. All rights reserved. For Permissions, please email: 
      journals.permissions@oup.com.
FAU - Backhouse, Tamara
AU  - Backhouse T
AD  - School of Health Sciences, University of East Anglia, Norwich, Norfolk, UK.
FAU - Killett, Anne
AU  - Killett A
AD  - School of Health Sciences, University of East Anglia, Norwich, Norfolk, UK.
FAU - Penhale, Bridget
AU  - Penhale B
AD  - School of Health Sciences, University of East Anglia, Norwich, Norfolk, UK.
FAU - Gray, Richard
AU  - Gray R
AD  - Nurse Education and Research Department, Hamad Medical Corporation, Doha, Qatar.
AD  - Office Of Nursing And Midwifery, LaTrobe University, Melbourne, Australia.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20160818
PL  - England
TA  - Age Ageing
JT  - Age and ageing
JID - 0375655
SB  - IM
MH  - Activities of Daily Living
MH  - Anthropology, Cultural
MH  - Attitude of Health Personnel
MH  - Behavior Control/*methods
MH  - Dementia/diagnosis/ethnology/psychology/*therapy
MH  - Health Knowledge, Attitudes, Practice
MH  - Health Personnel/education
MH  - *Homes for the Aged
MH  - Humans
MH  - Inservice Training
MH  - Interviews as Topic
MH  - *Nursing Homes
MH  - Qualitative Research
MH  - Quality of Life
MH  - Social Behavior
MH  - Treatment Outcome
MH  - Workforce
OTO - NOTNLM
OT  - BPSD
OT  - activities
OT  - care home
OT  - dementia
OT  - non-pharmacological intervention
OT  - older people
EDAT- 2016/08/21 06:00
MHDA- 2017/11/29 06:00
CRDT- 2016/08/21 06:00
PHST- 2015/10/20 00:00 [received]
PHST- 2016/06/17 00:00 [accepted]
PHST- 2016/08/21 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
PHST- 2016/08/21 06:00 [entrez]
AID - afw136 [pii]
AID - 10.1093/ageing/afw136 [doi]
PST - ppublish
SO  - Age Ageing. 2016 Nov;45(6):856-863. doi: 10.1093/ageing/afw136. Epub 2016 Aug 18.