A new study has provided a further note of caution about the use of antipsychotic drugs in dementia by recommending that non-pharmaceutical approaches should be the first line of approach when treating symptoms of agitation.
The study, published in International Psychogeriatrics was carried out by a team at the University of Exeter, US researchers at the University of Michigan and John Hopkins University. It examined the most up to date findings on the treatment of psychosis and agitation and ranked them in terms of effectiveness, finding that the top 4 interventions were all non-pharmaceutical.
Many experienced carers intuitively know that agitation and distress in people with dementia can often be treated without resorting to drugs with potentially dangerous side-effects, but this study provides further evidence to support this approach. Read on to learn how you adopt this approach in your service by reducing your reliance on antipsychotic drugs.
Antipsychotic Drugs in Dementia
The study found that skilled assessment and management of the underlying causes, carer education, environmental adaptations, person-centred care and a tailored activities programme were the most effective interventions in dealing with agitation. The highest ranked pharmaceutical interventions were Citalopram (6th) and Risperidone (7th) but these were recognised as having potential side-effects. Clearly, if alternatives to medication are this successful, you as a care provider have a responsibility to use them.
4 Steps to Treat Agitation in Dementia and Reduce Your Use of Antipsychotic Drugs
- Understanding behaviour: Understanding the reasons for a person with dementia’s behaviour is key to preventing agitation and distress. Taking a person-centred approach based on knowledge of their background and personal history will allow you to identify potential triggers and put in place preventative measures.
- Complementary therapies: Non-traditional therapies, such as aromatherapy, massage and reflexology, all have proven benefits in reducing agitation. These therapies can be used preventatively as part of daily care or as part of your ‘first aid kit’ to treat symptoms of agitation when they arise.
- Fulfilling activities: Agitation often results from boredom and under stimulation, so by ensuring that a person with dementia has the opportunity to take part in fulfilling and, where possible, purposeful activity, you will help reduce the frequency of episodes. For the more physically able, activities could include helping with tasks such as setting the table or taking part in exercise groups, whereas for those with later stage dementia, the use of twiddle mitts or sensory stimulation can be helpful.
- Music: As the saying goes, ‘Music has charms to soothe the savage breast’ and this is certainly true in the case of dementia care. The use of familiar tunes or perhaps even a specially tailored playlist, curated with the help of the person’s family, can improve their mood, aid relaxation and ease agitation.
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