Introduction
Non-pharmacological interventions are key strategies used in the management of dementia. Dementia is rising among older patients globally. With limited pharmacologic therapies, non-pharmacological interventions enhance the individual quality of life, thus which lead to a decrease in the number of persons with dementia and decrease in the intensity of dementia-related behavioral symptoms. This paper, however, utilizes selected articles to provide an overview of available evidence-based non-pharmacologic interventions in the community to reduce the symptoms of dementia. This paper will also depict the effectiveness of non-pharmacological interventions in managing dementia among older clients.
PICOT question
In elderly individuals with dementia living in long-term care facilities (P), does the implementation of non-pharmacological interventions (I), compared to the use of physical restraints (C), reduce agitation and aggression (O), without compromising safety and increasing the risk of falls (T)?
Article reviews
The article review journal by Berg-Weger et al. (2017) explored the non-pharmacologic interventions among clients with dementia in Missouri. The article depicts the essence of utilizing non-pharmacologic intervention as an alternative therapy to pharmacologic therapy to help reduce the increase of dementia among older clients. The number of older clients in Missouri accounts up to 100 000 older clients with dementia. However, cognitive impairment among this population is of concern for all healthcare providers. The researcher upholds the need of all healthcare providers to implement non-pharmacological interventions to help clients with dementia (Berg-Weger et al., 2017). The study utilizes cognitive stimulating therapy as an intervention to assist clients presenting with dementia.
The purpose of the study aimed to provide a review of the available evidence-based non-pharmacologic interventions and strategies to address dementia among older clients as well as to enhance the quality of life among this population. The study also utilizes this intervention to minimize the effect of dementia on the individual level of functioning. The article addressed the research question; what is the effectiveness of the available evidence-based interventions in reducing the symptoms, increasing the quality of life, and reducing the impact of dementia on individual well-being with dementia? Intervention discussed in the article, which includes; cognitive stimulation therapy, validation therapy, reminiscence therapy, and reality orientation, are significant for healthcare workers, especially nurses, to enhance and improve the quality of life of people with dementia and thus reduce the need for pharmacologic interventions (Berg-Weger et al., 2017). Objectively, the study reviewed available non-pharmacologic interventions such as validation therapy, reminiscence therapy, cognitive stimulation therapy, and reality orientation for persons with dementia.
The second article by Chen et al. (2021) sought to investigate the impacts of non-pharmacological interventions on agitation and aggression in elderly individuals with dementia. The study emphasized the importance of non-pharmacological strategies in relieving symptoms such as agitation and aggression in individuals with dementia. The study intended to find the effectiveness of non-pharmacological interventions in decreasing agitation and aggression since these behaviors can limit the quality of life for persons with dementia. The research question which typically guides the research study is which non-pharmacologic interventions are effective in decreasing agitation and aggression in individuals with dementia. The study involved 226 study participants and established that non-pharmacologic strategies such as group therapy, music therapy, massage, and activity therapy proved significant in reducing agitation and aggression in individuals with dementia. The results generated by Researchers in this study are significant to the nursing and healthcare system at large in that healthcare professionals can enact effective interventions, for instance, the ones generated in this study to reduce agitation and aggression, consequently improving the quality of life of clients with dementia.
Relationship to Nursing Practice
The first article exploring non-pharmacologic intervention for older persons with dementia provides an overview of various interventions such as; validation therapy, reality orientation, reminiscence therapy, and cognitive stimulation (Berg-Weger et al., 2017). These interventions are essential in the healthcare practice when managing older persons with dementia. The article shows this intervention enhances the quality of life for individuals with dementia.
The researchers in the second article conducted by Chen et al. (2021) utilized a prospective study to determine the effect of non-pharmacological intervention in decreasing agitation and aggression in individuals with dementia, thus generating various resourceful interventions vital in improving the quality of life of patients with dementia.
Both articles are instrumental in the nursing practice in myriad ways. The researchers add knowledge to the existing evidence-based non-pharmacologic interventions necessary in managing clients with dementia. The study conducted in Missouri among older clients provides varied interventions such as validation therapy, reminiscence therapy, and cognitive stimulation therapy (Berg-Weger et al., 2017). This evidence, based-non-pharmacological interventions solve the nursing practice problem of understanding various interventions helpful in managing individuals with dementia. However, the evidence from both articles adds knowledge on various non-pharmacological interventions helpful in managing individuals with dementia. Both outcomes from the studies conducted by the research are pertinent to the PICOT question as both studies tend to provide various non-pharmacological interventions necessary to treat individuals with dementia.
Method of Studies
Both studies adopt different methods of research designs. The first article reviews different non-pharmacological interventions for persons with dementia. The interventions reviewed and discussed included reminiscence therapy, validation therapy, cognitive stimulation therapy, and reality orientation. The second article adopts a prospective cohort study design in examining the various non-pharmacological interventions necessary to decrease agitation and aggression among clients with dementia.
Both studies focus on the effectiveness of non-pharmacological interventions in treating individuals with dementia. However, the study conducted by Berg-Weger et al. (2017) contrasts the second article in that it focuses on specific interventions such as reminiscence therapy, cognitive stimulation therapy, reality orientation, and validation therapy, while the prospective cohort study designs explored various interventions that helped in decreasing agitation and aggression among clients with dementia.
The benefit of the first article is that it offers an overview of specific non-pharmacological interventions necessary for managing individuals with dementia. This adds knowledge to the existing interventions. The second article provides the impact of non-pharmacological interventions on agitation and aggression in older clients with dementia. The limitation of the first article is the focus on specific interventions with limited in-depth analysis, while the second utilizes few study participants as well as a narrow range of interventions necessary.
Results of Studies
In summary, the study conducted by Berge-wedger et al. (2017) examined non-pharmacological intervention for persons with dementia and provided analysis of essential interventions such as cognitive stimulation, validation therapy, reality orientation, and reminiscence therapy, which provide significant in the treatment of individuals with dementia. The second article depicts the importance of non-pharmacological interventions in treating aggression and agitation in individuals with dementia.
Both studies offer imperative implications for the nursing practice. From the studies, nurses can enact and utilize various non-pharmacologic interventions necessary to manage older clients with dementia. Nurses should always be mindful of utilizing these interventions as they help elderly clients with dementia. Additionally, nurses can explore various non-pharmacologic therapies vital in relieving symptoms of dementia.
Ethical considerations
Ethical considerations play a significant role in conducting research. Ethical considerations include obtaining informed consent and enhancing confidentiality throughout the research process (Green & Johnson, n.d). Informed consent entails study participants being aware of what is all the research about and should give their stake to either take part in the research or exit the research. Confidentiality entails maintaining privacy and respecting the client’s rights through the research process. Both research articles sought informed consent before conducting the semi-structured interviews. Moreover, study participants were assured of their confidentiality.
Conclusion
The effectiveness of the non-pharmacological intervention is resourceful in managing elderly clients with dementia. Both studies enrich the management of dementia among elderly clients through discussion of various significant interventions, for instance, validation therapy, reminiscence therapy, and cognitive stimulation therapy. Nursing practice is enriched with knowledge about varied techniques for managing elderly clients with dementia. The various interventions discussed in the studies apply to nursing practices. Hence nurses are instrumental care providers in caring the elderly clients with dementia as per the stipulated interventions. Finally, besides pharmacological therapy, non-pharmacological modalities are paramount in the treatment of elderly clients with dementia.
References
Berg-Weger, M., & Stewart, D. B. (2017). Non-pharmacologic interventions for persons with dementia. Missouri medicine, 114(2), 116.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140014/
Chen, X., Wang, J., & Liu, L. (2021). The impact of non-pharmacological interventions on agitation and aggression in elderly individuals with dementia: A prospective cohort study. International Journal of Nursing Studies, 108, 103706.
Green, S. & Johnson, J. (n.d.). Research ethics and evaluation of qualitative research in Helbig, J. (n.d.) History and process of nursing research, evidence-based nursing practice, and quantitative and qualitative research. From: https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/2
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