Improving Management of Behavioral and Psychological Symptoms of Dementia in Acute Care: Evidence and Lessons Learned From Across the Care Spectrum.

Published

Journal Article

As the prevalence of Alzheimer disease and related dementias increases, dementia-related behavioral symptoms present growing threats to care quality and safety of older adults across care settings. Behavioral and psychological symptoms of dementia (BPSD) such as agitation, aggression, and resistance to care occur in nearly all individuals over the course of their illness. In inpatient care settings, if not appropriately treated, BPSD can result in care complications, increased length of stay, dissatisfaction with care, and caregiver stress and injury. Although evidence-based, nonpharmacological approaches to treating BPSD exist, their implementation into acute care has been thwarted by limited nursing staff expertise in behavioral health, and a lack of consistent approaches to integrate behavioral health expertise into medically focused inpatient care settings. This article describes the core components of one evidence-based approach to integrating behavioral health expertise into dementia care. This approach, called STAR-VA, was implemented in Veterans' Health Administration community living centers (nursing homes). It has demonstrated effectiveness in reducing the severity and frequency of BPSD, while improving staff knowledge and skills in caring for people with dementia. The potential for adapting this approach in acute care settings is discussed, along with key lessons learned regarding opportunities for nursing leadership to ensure consistent implementation and sustainability.

Full Text

Duke Authors

Cited Authors

  • McConnell, ES; Karel, MJ

Published Date

  • July 2016

Published In

Volume / Issue

  • 40 / 3

Start / End Page

  • 244 - 254

PubMed ID

  • 27259128

Pubmed Central ID

  • 27259128

Electronic International Standard Serial Number (EISSN)

  • 1550-5103

International Standard Serial Number (ISSN)

  • 0363-9568

Digital Object Identifier (DOI)

  • 10.1097/naq.0000000000000167

Language

  • eng