Table 4.

Nonpharmacologic strategies for neuropsychiatric symptoms in dementia

Symptom	Strategies
Depression/apathy	Introduce/encourage enjoyable activities Modify activities patient has enjoyed in the past to fit current level of function to avoid frustration Consider repetitive activities (eg, folding laundry, sorting papers) Introduce/encourage social activities, outings Address caregiver depression
Agitation	Identify and avoid triggers Maintain structured daily routines Stay calm; avoid arguing, reasoning Redirect and distract
Wandering	Provide labels or visual cues (eg, arrows to bathroom, bedroom, stop signs) Disguise exits Provide supervision (eg, family, paid caregivers, adult day programs) Introduce/encourage enjoyable activities Develop a safety plan (eg, “Safe Return” program)
Hallucinations/delusions	If not disturbing or frightening, allow patient their experience of the truth; avoid reasoning or attempting to correct patient’s perceptions If disturbing or frightening provide calm reassurance, distract and redirect, consider medication
Disorientation	Simplify environment, reduce clutter, noise Provide visual cues and reminders Provide verbal prompts Identify self and others
Sleep disturbance	Maintain consistent sleep times and routines Avoid daytime napping Reduce/eliminate alcohol and caffeine Reduce/eliminate noise, distractions Consider bright light exposure