Exploration of non-pharmalogical interventions in the management of behavioural and psychological symptoms of dementia

Abstract

Introduction: Behavioural and Psychological Symptoms of Dementia (BPSD) are considered as integral parts of dementia. Whilst pharmacotherapy is reserved for severe symptoms of BPSD, the associated adverse effects can be detrimental. Therefore, non-pharmacological intervention is recommended to be the frontline in the management of BPSD. This study aimed to explore the non-pharmacological approaches for the management of BPSD including the strategies and barriers of implementing them in secondary care facilities in Malaysia. Methods: A qualitative study design was employed. Data were collected through observations and semi-structured interviews of twelve caregivers and eleven people with dementia (PWD) at seven secondary care facilities. Observations were written in the field notes and interviews were audio-recorded and transcribed. All data were subjected to thematic analysis. Results: Some personalised non-pharmacological interventions such as physical exercise, music therapy, reminiscence therapy, and pet therapy were conducted in several nursing care centres. Collaborative care between care providers and family members was found to be an important facilitating factor. Hence, lack of family support led to additional workload, which were beyond the job scope of the care providers. Other barriers identified for non-pharmacological interventions were cultural and language differences between care providers and PWD, inadequate staff numbers and training, as well as time constraints. Conclusion: Although non-pharmacological approaches have been conducted to some extent in Malaysia, continuous education and training for the healthcare providers as well as the family members of PWD are needed to overcome the challenges with regards to their successful implementation.