medigraphic.com
ISSN 1561-2961 (Print)

2019, Number 4

<< Back Next >>

Rev Cuba Enf 2019; 35 (4)

Nonpharmacological Interventions for Managing Agitation in Elderlies with Dementia in the Home Setting

Luiza RJ, Barbosa de Sá Diaz FB, Santana CB, Ribeiro L, da Costa CF; Rezende-Alves K

Language: Portugu?s
References: 31
Page: 1-15
PDF size: 318.85 Kb.


ABSTRACT

Introduction: Agitation is a neuropsychiatric symptom recurrent in elderly people with dementia. In the daily life of the home setting, this condition imposes on the family caregivers the challenge of finding appropriate management strategies for avoiding visits to the emergency room, hospitalizations, or even long-term institutionalization. Objective: To identify the nonpharmacological strategies used by family caregivers in the management of agitation in elderly people with dementia.
Methods: Qualitative research carried out with 11 family caregivers of elderly people in Minas Gerais, Brazil. The data collection was carried out through interviews with semi-structured repertory of quotations. The content analysis technique was used to interpret the data.
Results: The most commonly used strategies for agitation management were identified. These were conversation, listening, distraction, use of toys, music/singing, and reading the Bible for accessing spirituality or religiosity. It was verified that, in the face of the challenges imposed by dementia onto the care and the physical and emotional outwearing experienced, family caregivers strived to welcome and provide human support to the elderly relative, in addition to feeling satisfied to have the opportunity to give back the care received.
Conclusions: There is no intervention capable of responding effectively to all agitation-related behaviors. However, the experience and the relationship developed between family caregivers and the elderly guided the individual choice for the most effective nonpharmacological interventions, probably by providing some anticipation to the elderly’s responses.


REFERENCES

  1. Alzheimer’s Disease International. World Alzheimer Report 2018. The state of the art of dementia research: New frontiers. London. 2018 [acesso: 10/01/2019]. Disponible en: https://www.alz.co.uk/research/WorldAlzheimerReport2018.pdf

  2. International Psychogeriatric Association. The IPA complete guides to behavioral and psychological symptoms of dementia. International Psychogeriatric Association. 2012 [acesso: 08/01/2019]. Disponible en: http://www.bsa.ualberta.ca/sites/default/files/____IPA_BPSD_Specialists_Guide_Online.pdf

  3. Tible OP, Riese F, Savaskan E, Von Gunten A. Best practice in the management of behavioural and psychological symptoms of dementia. Therapeutic Advances in Neurological Disorders. 2017 [acesso: 08/01/2019];10(8):297-309. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5518961/pdf/10.1177_1756285617712979.pdf

  4. Kales HC, Gitlin LN, Lyketsos CG. Assessment and management of behavioral and psychological symptoms of dementia. BMJ. 2015 [acesso: 05/01/2019];350(027):369. Disponible en: https://www.bmj.com/content/350/bmj.h369

  5. Steinberg M, Shao H, Zandi P, Lyketsos CG, Welsh-Bohmer KA, Norton MC, et al. Point and 5-year prevalence of neuropsychiatric symptoms in dementia: the Cache County Study. Int J Geriatr Psychiatry. 2008 [acesso: 15/01/2019];23:170-7. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2932652/

  6. Terum TM, Andersen JR, Rongve A, Aarsland D, Svendsboe EJ, Testad I. The relationship of specific items on the Neuropsychiatric Inventory to caregiver burden in dementia: a systematic review. Int J Geriatr Psychiatry. 2017 [acesso: 15/01/2019];32(7):703-17. Disponible en: https://onlinelibrary.wiley.com/doi/full/10.1002/gps.4704

  7. Cummings J, Mintzer J, Brodaty H, Sano M, Banerjee S, Devanand DP, et al. Agitation in cognitive disorders: International Psychogeriatric Association provisional consensus clinical and research definition. International Psychogeriatrics. 2014 [acesso: 10/07/2019];27(1):7-17. Cambridge University Press. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301197/pdf/S1041610214001963a.pdf

  8. Gilhooly KJ, Gilhooly MLM, Sullivan MP, McIntyre A, Wilson L, Harding E, Woodbridge R, et al. A meta-review of stress, coping and interventions in dementia and dementia caregiving. Bmc Geriatrics. 2016; 16(1):1-8. Springer Nature. Acesso: 08/07/2019. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4872341/.

  9. Oliveira AM, Radanovic M, Homem de Mello PC, Buchain PC, Vizzotto ADB, Celestino 9. Stella F. Nonpharmacological Interventions to Reduce Behavioral and Psychological Symptoms of Dementia: A Systematic Review. Biomed Res Int. 2015 [acesso: 18/01/2019];2015:1-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676992/

  10. Cohen-Mansfield J. Nonpharmacologic Interventions for Inappropriate Behaviors in Dementia: A Review, Summary, and Critique. Am J Geriatr Psychiatry. 2001 [acesso: 15/01/2019];9(4):361-81. Disponible en: https://www.sciencedirect.com/science/article/pii/S1064748112614511?via%3Dihub

  11. Bessey LJ, Walaszek A. Management of Behavioral and Psychological Symptoms of Dementia. Current Psychiatry Reports. 2019 [acesso: 10/07/2019];21(8):1-11. Springer Science and Business Media LLC. Disponible en: https://link-springer-com.ez27.periodicos.capes.gov.br/article/10.1007/s11920-019-1049-5

  12. Perdigão LMNB, Almeida SC, Assis MG. Estratégias utilizadas por cuidadores informais frente aos sintomas neuropsiquiátricos de idosos com demência. Rev Ter Ocup Univ São Paulo. 2017 [acesso: 30/01/2019];28(2):156-62. Disponible en: http://www.revistas.usp.br/rto/article/view/126244

  13. Delfino LL, Cachioni M. Estratégias comunicativas de cuidadores de idosos com demência: uma revisão sistemática. J Bras Psiquiatr. 2016 [acesso: 30/01/2019];65(2):186-95Disponible en: http://www.scielo.br/pdf/jbpsiq/v65n2/0047-2085-jbpsiq-65-2-0186.pdf

  14. Desai AK, Desai FG. Management of Behavioral and Psychological Symptoms of Dementia. Current Geriatrics Reports. Springer Science and Business Media LLC. 2014 [acesso 10/07/2019];3(4):259-72. Disponible en: https://link-springer-com.ez27.periodicos.capes.gov.br/content/pdf/10.1007%2Fs13670-014-0099-0.pdf

  15. Fontanella BJB, Luchesi BM, Saldel MG, Ricas J, Turato ER, Melo DG. Amostragem em pesquisas qualitativas: proposta de procedimentos para constatar saturação teórica. Cad Saúde Pública. 2011 [acesso: 22/10/2018];27(2):389-93. Disponible en: http://www.scielo.br/pdf/csp/v27n2/20.pdf

  16. Bardin L. Análise de Conteúdo. Tradução: Luís Antero Reto e Augusto Pinheiro. Lisboa: Edições 70; 1977.

  17. Bremenkamp MG, Rodrigues LR, Lage RR, Laks J, Cabral HWS, Morelato RL. Sintomas neuropsiquiátricos na doença de Alzheimer: frequência, correlação e ansiedade do cuidador. Rev Bras Geriatr Gerontol. 2014 [acesso: 10/01/2019];17(4):763-73. Disponible en: http://www.scielo.br/pdf/rbgg/v17n4/1809-9823-rbgg-17-04-00763.pdf

  18. Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology. 1997 [acesso: 10/01/2019];48(6):10-6. Disponible en: http://n.neurology.org/content/48/5_Suppl_6/10S.full

  19. Patterson MG, Cuesta YP, Lemus ECC. Malestar psicológico en cuidadores principales de pacientes con enfermedad de Alzheimer. Rev Cubana Enferm. 2018 [acesso: 25/01/2019];34(3):389-96. Disponible en: http://scielo.sld.cu/pdf/enf/v32n3/enf120316.pdf

  20. Cheng ST. Dementia Caregiver Burden: a Research Update and Critical Analysis. Curr Psychiatry Rep. 2017 [acesso: 25/01/2019];19(9):1-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5550537/

  21. Kolanowski A, Boltz M, Galik E, Gitlin LN, Kales HC, Resnick B, et al. Determinants of behavioral and psychological symptoms of dementia: A scoping review of the evidence. Nurs Outlook. 2017 [acesso: 25/01/2019];65(5):515-29. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/28826872

  22. Van Vacrem M, Spruytte N, Declercq A, Van Audenhove C. Nighttime restlessness in people with dementia in residential care: an explorative field study. Tijdschr Gerontol Geriatr. 2016 [acesso: 25/01/2019];47(2):78-85. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/26886877

  23. Meira EC, Reis LA, Gonçalves LHT, Rodrigues VP, Radl PR. Vivências de mulheres cuidadoras de pessoas idosas dependentes: orientação de gênero para o cuidado. Esc. Anna Nery. 2017 [acesso: 30/01/2019];21(2):1-8. Disponible en: http://www.scielo.br/pdf/ean/v21n2/1414-8145-ean-21-02-e20170046.pdf

  24. De Vries K. Communicating with older people with dementia. Nurs Older People. 2013 [acesso: 16/01/2019];25(4):30-7. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/23789241

  25. James IA, Mackenzie L, Mukaetova-Ladinska E. Doll use in care homes for people with dementia. Int J Geriatr Psychiatry. 2006 [acesso: 25/01/2019];21:1093-8. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/16955418

  26. Santos RAAS, Corrêa RGCF, Rolim ILTP, Coutinho NPS. Atenção no cuidado ao idoso: Infantilização e desrespeito à autonomia. Rev Pesq Saúde. 2016 [acesso: 15/01/2019];17(3):179-83. Disponible en: http://www.periodicoseletronicos.ufma.br/index.php/revistahuufma/article/view/6793

  27. Zhang Y, Cai J, An L, Hui F, Ren T, Ma H, et al. Does music therapy enhance behavioral and cognitive function in elderly dementia patients? A systematic review and meta-analysis. Elsevier. Ageing Research Reviews. 2017 [acesso: 10/07/2019];35:1-11. Disponible en: https://www.sciencedirect.com/science/article/pii/S156816371630280X?via%3Dihub

  28. Gómez-Romero M, Jiménez-Palomares M, Rodríguez-Mansilla J, Flores-Nieto A, Garrido-Ardila EM, González López-Arza MV. Beneficios de la musicoterapia en las alteraciones conductuales de la demencia. Elsevier. Revisión sistemática. Neurología. 2017 [acesso: 10/07/2019];32(4):253-263. Disponible en: https://www.elsevier.es/es-revista-neurologia-295-articulo-beneficios-musicoterapia-las-alteraciones-conductuales-S0213485314002485

  29. Rio R. A Community-Based Music Therapy Support Group for People With Alzheimer's Disease and Their Caregivers: A Sustainable Partnership Model. Front Med. 2018 [acesso: 18/02/2019];5:1-7. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/30460236

  30. Silva MCM, Moreira-Almeida A, Castro EAB. Elderly caring for the elderly: spirituality as tensions relief. Rev Bras Enferm. 2018 [acesso: 10/01/2019];71(5):2461-8. Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-71672018000502461

  31. Gijsberts MJHE, Liefbroer AI, Otten R, Olsman E. Spiritual Care in Palliative Care: A Systematic Review of the Recent European Literature. Medical Sciences. 2019 [acesso: 10/07/2019];7(2):25-46. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409788




2020     |     www.medigraphic.com