Page 99 - HA Convention 2016 [Full Version]

Masterclasses HOSPITAL AUTHORITY CONVENTION 2016

M1.3 Dementia Management 10:45 Room 221

Non-drug Treatment for Behavioural and Psychological Symptoms of Dementia
Lee YY
Occupational Therapy Department, Kwai Chung Hospital, Hong Kong

Introduction Tuesday, 3 May

Prevalence of behavioural and psychological symptoms of dementia (BPSD) was very high in dementia patients (Shaji,
George, Prince & Jacob, 2009).

Non-pharmacological Interventions

Treatment of dementia includes pharmacological and non-pharmacological interventions. Several systematic reviews and
an overview of non-pharmacological intervention have been done by different professionals and occupational therapists,
who recommended non-pharmacological treatment as an evidence-based practice for formal and informal carers (Hulme,
Wright, Crocker, Oluboyede, & House, 2010; Lee et al., 2012; Olazaran et al., 2010). They include intervention of cognitive,
activities of daily living (ADL) and behavioural and psychological symptoms aspects. The recommended evidence-based and
effective non-drug treatment on BPSD include cognitive rehabilitation, Snoezelen/multisensory stimulation, reality orientation,
reminiscence therapy, validation therapy, physical activity, ADL and functional training, enviromental adaptation, Montessori-
based programme, remotivation therapy, light therapy, music therapy, aromatherapy, animal-assisted therapy, massage/touch
therapy, behavioural intervention and activity scheduling, and community occupational therapy programme with cognitive
and behavioural intervention (Arbesman & Lieberman, 2011; Clare, 2010; Hulme, Wright, Crocker, Oluboyede & House, 2010;
Douglas, James & Ballard, 2004; Lam et al., 2010; Lee et al., 2012; Mok, 2004; Oliveira et al., 2015; Van der Ploeg, Eppingstall,
Camp, Runci, Taffe, & O’Connor, 2013; Yamaguchi, Maki & Yamagami, 2010). Occupational therapists, different professionals
and caregivers might select evidence-based intervention programme for clients with dementia depending on their needs,
background, interests, cognitive and functional performance and the environment they are living in.

Randomised controlled trial studies on community occupational therapy for older clients with dementia showed that
occupational therapy programme, including cognitive and behavioural intervention showed significant improvement in
functional performance, mood, health status and quality of life in subjects of intervention group, and their care givers also
demonstrated significant improvement in health status (Graff, Vernooij-Dassen, Thijssen, Dekker, Hoefnagels & Rikkert, 2006,
2007 & 2008).

Conclusion

Client-centred approach, caregiver training and multidisciplinary treatment are important in successful management of BPSD.

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