A Scoping Review of Dementia Symptom Management in Persons with Dementia Living in Home-Based Settings

A large proportion of our older adults live with Alzheimer’s disease and related dementias, and the number of those diagnosed in the future is expected to increase dramatically as the population ages. Persons with dementia bring unique healthcare challenges due to the manifestation of behavioral and psychological symptoms associated with the disease. The lack of geriatric clinicians as well as a properly trained non-geriatric specialist workforce capable of addressing the symptoms persons with dementia exacerbates the challenge of providing effective care. Pharmacological interventions are contraindicated for treatment of most behavioral psychological symptoms of dementia (BPSD). The Centers for Medicare and Medicaid Services now requires that nonpharmacological interventions be used as a first-line treatment. It has not been determined what nonpharmacological intervention for BPSD are most effective and what the infrastructure would entail for such interventions for PWD living at home.

The purpose of this study is to examine the literature focusing on interventions aimed towards managing persons’ symptoms of dementia living in home-based settings. A scoping review examining the literature published on this topic over the last 3 years was conducted.

One thousand twenty-four articles were found, of which nine met inclusion criteria. Five articles used occupation-based therapy, two used exercise therapy, and one article was found utilizing aromatherapy and music therapy.

The majority of articles used occupation-based therapy as their intervention for BPSD. Overall, research showed nonpharmacological interventions can be effective in helping mange BPSD in persons living in home-based settings, although maintenance effects of interventions should be further explored in future research as well as how to ensure these interventions are more widely utilized by caregivers in this setting.