Table 3.
Nonpharmacologic Management Techniques for Patients With Dementia-Related Psychosis and Parkinson Disease Psychosis in an LTC Setting
| Nonpharmacologic Management Approach | Description of Approach | Reference |
|---|---|---|
| ABC approach47 |
Activating event: An event that elicits a behavioral outburst from a patient Behavior: A patient displays a negative reaction (eg, anger, confusion) to the activating event Consequence: Staff deescalate the situation while speaking to the patient with respect to maintain dignity Decide and Debrief: Once patient is calm, staff and patient discuss the activating event |
http://www.dementiamanagementstrategy.com/Pages/ABC_of_behaviour_management.aspx |
| DICE approach48 |
Describe: Describe symptoms and context of symptoms with caregiver(s) and patient Investigate: Identify potential causes, and determine which are modifiable Create: Create a treatment plan (including medical, nonpharmacologic, or pharmacologic treatments) Evaluate: Assess outcomes of strategies used and if caregiver and patient distress was reduced |
https://diceapproach.com/ |
| The Psychosocial-Environmental Model49,50 | Caregivers should take residents seriously, not redirect subjects when they are expressing concern or fear, show patience, empathy, sympathy, and avoid taking insults or accusations personally. Additional therapies are recommended to reduce behavioral symptoms, including provision of structured or unstructured activities, music, exercise, simulated presence therapy, validation therapy, aromatherapy, or reminiscence therapy |
https://www.youtube.com/watch?v=ESqfW_kyZq8 Psychiatric Consultation in Long-Term Care: A Guide for Health Care Professionals49 |
| STAR Program51, 52, 53 | Staff training to build knowledge and skills that facilitate the ABC approach. Training includes education on dementia in daily life, verbal and nonverbal skills for communicating with residents with dementia, incorporating pleasant events into resident life, improving communication with families, and how to use the ABC approach |
https://www.apa.org/pi/about/publications/caregivers/practice-settings/intervention/star-caregivers STAR: A Dementia-Specific Training Program for Staff in Assisted Living Residences51 |
| STAR-C-TM53 | Composed of 8 weekly sessions between a caregiver and HCP via one-on-one teleconference. Sessions focus on training caregivers in the STAR program without an in-person visit | “It Took the Stress out of Getting Help”: The STAR-C-Telemedicine Mixed Methods Pilot53 |
HCP, health care provider.