Interventions Aimed at the Carers

This category includes interventions designed to identify the cause of BPSD in the dementia dyad or family or is aimed at formal carers, i.e., nursing home staff. De Vugt et al. (2004) found that nonacceptance of the illness by a carer was associated with higher risk of hyperactivity, highlighting the importance of focusing on the carer [123]. The authors speculated that hyperactivity was a result of interaction between patient and carer. Specifically that impatience, irritability, and anger toward the patients may trigger hyperactive behavior.

Approaches include functional analysis-based intervention (the ABC approach) and tailoring activities for patient and carers, identifying triggers, and educating carers on how to modify those triggers, enabling carers to identify the patient’s level of ability to problem-solve. A meta-analysis suggested that functional analysis- based interventions may be efficacious for challenging behavior but also that further studies are needed [124]. Livingston et al. (2005) [97] divided interventions which were designed to work through care staff aimed at agitation into person-centered care and dementia care mapping [125-128]. Both types of interventions were found to decrease agitation during and after the intervention. However, only a single RCT was identified regarding dementia care mapping. Furthermore, unsupervised communication skills trainings were not efficacious [125].

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