Effectiveness of Nonpharmacological Interventions for the Management

Question: Discuss about the Effectiveness of Nonpharmacological Interventions for the Management? Answer: Identification of the themes In a research carried out by KayeErvin and colleagues carried out a broad research on the barriers which are important to manage the psychological and behavioral symptoms regarding dementia. This particular study was carried out from the perception of the staffs of the medical facilities. In a study related to such behavior and prospective of the relatives and staffs, carried out by Duxbury and his colleagues regarding the relatives and staffs perspective regarding the aggression during the period of dementia at care units are needed to be seriously researched In a study by Liat Ayalan and colleagues have suggested that the general pharmacological interventions for the treatment of neuropsychiatric symptoms and for the treatment sometimes increase the risk of death of the patients They also suggested that these drugs are comparatively more risky for the treatment of older adults. In their study, they reviewed psyc-INFO, relevant published bibliographies, Cochrane library and MEDLINE along with the guidelines of American Psychological Association. In a research article by Ann Kolanowski and colleagues, the main purpose of the research was to provide the people with a strong evidence base that it will indicate that the cultural change in the medical facilities and nursing homes can provide an impact in case treatment of dementia. Like other researchers, they also conducted the study through the implementation of a focus group study In a study carried out by Jiska and colleagues, a broader comparison was made between the physicians, nurse practitioners and psychologists. This study can be considered to be one of the most important one as it differentiates the role of different medical intervention providers. The main aspect of the study is the different background and training of the personnel who treat the behavioral issues or problems in residents. In a study carried out by Farooq Khan and Martin Curtice rgarding the same topic suggested that the self reported knowledge regarding the common mental health problems and the dementia has increased in facilities such as care home staff at the very end of this particular project by a margin of seven percent and eleven percent respectively. A study regarding this topic was carried out by Audyery Deudon and colleagues. The article was mainly focused on the behavioral and psychological symptoms of dementia also known as BPSD and the effectiveness of the staff education intervention in order to manage BPSD in the older people who are suffering from dementia. A study carried out by Jiska and Barbara regarding the knowledge of the nursing home physician and their attitudes help to collect more knowledge regarding this particular aspect. They suggested that the frequency at which the behavioral problems regarding dementia were attributed to the psychological and environmental causes only suggest that there are a large number of cases where non pharmacological interventions could be and should be implemented. In another article by Kristie and her colleagues, factors regarding which the success of the management program can be promoted is broadly discussed.; the authors suggested that use of multiple non pharmacological interventions are often associated with the likelihood of the success of the management program. In an article by Hazelhof and colleague, the author suggested that educating the nursing staffs effectively play a vital role. In some cases it is observed that the right intervention or techniques is often not used at the right time. In an article by Ervin and his colleagues, it is observed that in many facilities, the staffs taking care of the patients possess a sound knowledge of the possible underlying causes regarding the BPSD. But in many cases it is also observed that the poor ability to understand the effective methods for the management and the resources available to them. Critical analysis of themes In order to complete any sort of literature review, it is very important to critically analyze the entire selected article and their themes for the better understanding of the subject and matter as well. From all the articles mentioned earlier, it can be stated that the important themes which are highlighted are the residential facilities for the aged persons are nowadays increased the usage of pharmacological interventions to manage the BPSD events such as antipsychotics. Though there is a very little amount of scientific proof that these pharmacological are effective, irrespective of these fact, the facilities are using such interventions. Another aspect on which the author emphasized is that the different non pharmacological approaches for the management of these behavioral and psychological symptoms of dementia which is also known as BPSD. From this particular study it can be noted that there are several residential aged care facilities which do not favor such non pharmacological interventions irrespective of their effectiveness. Through the different case studies regarding dementia, one phenomenon which should be highlighted and kept in mind is the aggressive nature and behavior of the older people at the time of suffering from dementia. In terms of this particular aspect there is the phenomenon or incidents where the behavior of the staffs and relative with respect to these situations also changes. In a study related to such behavior and prospective of the relatives and staffs, carried out by Duxbury and his colleagues regarding the relatives and staffs perspective regarding the aggression during the period of dementia at care units are needed to be seriously researched. In these studies, they have interviewed various nursing staffs and relatives of the patients in the different care homes of the United Kingdom. Through the usage of a combine approach of one to one interview procedure, and different focus groups, the authors explored the views of the each individual. Implementing a thematic analysis they found that the views of both the staffs and the relatives can be categorized in two different categories. As a result they figured out that non pharmacological interventions such as can reduce the behavioral problems significantly in comparison with the pharmacological intervention. They also concluded that, the cumulative research till date regarding the effects of non pharmacological intervention for purpose of treating neuropsychiatric symptoms or NPS among the patients suffering from dementia indicated that intervention which addresses behavioral issues along with unmet needs, bright light therapy can be more effective than the conventional pharmacological methods. They also concluded that, in order to be sure regarding such proposals, a further broad amount of study is needed on this particular topic (Ayalon et al. 2006). That changing landscape, behaviors of the residents, reaching out to the patient of dementia along with dif ferent educational aspects for the proper training of the nursing home staffs are also needed and may play a vital role. They concluded that the successful usage of non pharmacological intervention requires the right amount of skilled and trained staffs to yield the best positive outcome from the intervention. If the staffs are not well enough trained and the vulnerability of the framework of the entire intervention model will be exploited and this entire situation will do no good for the patient. One which should be also kept in mind with respect to this particular context is the, the effect change in the facilities like nursing home, implementation of staff patterns which can allow the staffs to make a difference with the help of BPSD and development of an effective educational program can play an important role (Kolanowski et al. 2010). The amount of reported confidence in the management of the behavioral problems has increased about nine percent among the care home staffs at the end of their final project. They carried out regular monitoring during the time of project regarding the psychotropic medications as well. The article also provided some vital guidelines regarding the non pharmacological interventions for the management of BPSD. It also included different relaxation techniques, needs led therapy, reminiscence work, reality orientation programs, music therapy, distraction techniques etc (Khan and Curtice 2011). at the end of it, physical restraints should be categorized as the last resort. In many cases, the patients are often restrained for the completion of the intervention. They suggested that it is not a good practice and in most of the cases such actions should be avoided. They also suggested that large physical aggression in both men and women are often suspected to be psychiatric comorbidity which are often difficult to manage. In such cases family involvement and their support play an important role and in certain cases they should be used a s well for the betterment of the patient (Hazelhof et al. 2014). As a result the outcome of the intervention is not as desired and the situation of the patient also does not get better. For overcoming such phenomenon, the authors of this particular article suggested that proper training and education to the nurses is the most vital aspect in case treating the patients of dementia with no pharmacological intervention (Ervin et al. 2012). Discussion and knowledge/research gap identified From all the above mentioned articles and their research themes, it can be stated that all of them emphasized on the fact that there is a huge need of non pharmacological interventions for the treatment purposes of BPSD. Along with all these aspects, another thing which is highlighted is that there is also a lack of knowledge among the medical staffs and care providers regarding the non pharmacological interventions. Another aspect which is also mentioned with respect to the current scenario is that there is lack of execution capability among the staffs as well. Adding to this it can be also stated that there are some evidenced found from the research articles that non pharmacological interventions are actually more effective than conventional pharmacological intervention. It is also observed that the conventional pharmacological drugs which are used to treat in the normal BPSD patient treatment possess a great amount of threat regarding the side effects. Along with all of these posi tive aspects, there are some negative aspects of all the articles mentioned above. Another thing which is needed to be addressed is that from this article it can be said that the management of the interventions are important so as the role and mindset of the nurses and family relatives as well. All of these articles have suggested that the non pharmacological interventions are more helpful and applicable in case of treating the patients suffering from BPSD. But they have not been able to suggest proper guidelines and structure to apply non pharmacological methods and monitoring procedures as well. Along with this another thing which should be mentioned is that they did not provide any evaluation processes as well. As a result, the only outcomes of the above mentioned articles can be pointed out as, Non pharmacological interventions should be applied in case of treating patients suffering from BPSD Most of the drugs which are used to treat people suffering from BPSD are causing severe side effects Most of the medical staffs and care givers such as nurses either have lack of knowledge or lack of execution power in order to apply non pharmacological procedures The articles hav not provided any such guidelines or protocols which are needed to be followed for implementing non pharmacological interventions Articles are unable to suggest any new and effective non pharmacological interventions. Conclusion In recent times, dementia has been considered to be one of the major diseases which cause memory loss and hamper the daily life of an individual. In order to overcome this situation the main aspect is needed to be identification of the behavioral changes and different physiological symptoms regarding dementia. Another aspect which is needed to be considered is that the relatives of patient should play an important and supportive role to the patient as the disease can demoralize the patient. As a result the support coming from the medical staffs also play an important in order to provide hope to the patient. There are several forms of intervention for the purpose o remedy of dementia. These forms can be categorized into pharmacological intervention and non pharmacological intervention. In recent times, maximum medical experts are emphasizing on the use of non pharmacological intervention in comparison with the pharmacological intervention. The main reason behind such choice is that it is both effective and does not cause any side effects to the patient. One of the major reasons for fascinating this method of medical intervention is that it emphasizes on the cognitive behavioral method. This is considered to be one of the most effective non pharmacological interventions for the treatment of the patients suffering from dementia. The purpose of this literature review is to highlight the aspects of above mentioned factors with respect to the findings of different scientists into their journals or research articles (Ervin et al. 2014). From all these aspects and information, it can be said that the training and the education of the staffs that are associated in the nursing homes and other care facility for the purpose of providing care to the patients who are old and suffering from dementia is needed. Another aspect which is highlighted through all these studies is that the family and relatives of the patients should also be supportive to the non pharmacological inte rvention. Non pharmacological interventions are still now considered to be effective than the pharmacological intervention and has a broader aspect in the treatment process as well. References Ayalon, L., Gum, A.M., Feliciano, L. and Aren, P.A., 2006. Effectiveness of nonpharmacological interventions for the management of neuropsychiatric symptoms in patients with dementia: a systematic review.Archives of internal medicine,166(20), pp.2182-2188. Cohen-Mansfield, J. and Jensen, B., 2008. Nursing home physicians' knowledge of and attitudes toward nonpharmacological interventions for treatment of behavioral disturbances associated with dementia.Journal of the American Medical Directors Association,9(7), pp.491-498. Cohen-Mansfield, J., Jensen, B., Resnick, B. and Norris, M., 2012. 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