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Introduction Dementia is a syndrome of a progressive decline in multiple physical and intellectual areas. ‘Behavioural and psychological symptoms of dementia’ are usually addressed with pharmacological interventions (i.e., antipsychotics) as the first choice, while ‘person-centred care’ is an effective alternative-toantipsychotics approach. The purpose of this integrative literature review was to explore the literature on effective alternative-to-antipsychotics strategies to manage behavioural and psychological symptoms of dementia; to inform family physicians about alternative-to-antipsychotics strategies; and to suggest implementation of alternative-to-antipsychotics interventions to prevent or delay older adults’ cognitive decline. Methods To address the aims of this review, we searched Medline and Cumulative Index to Nursing and Allied Health Literature databases, and cross referenced publications using the following keywords and terms: antipsychotics, elderly, older adults, long-term care facilities/ settings, alter native to antipsychotics interventions. The aim of this review was to discuss if there are any effective alternative to antipsychotics strategies in dementia. Discussion Social engagement and modifiable lifestyle habits (e.g., lifelong learning, mental and physical exercise) are protective factors for cognitive vitality in aging and decreased risk of dementia. Recommendations include an emphasis upon person-centred care, safe environment, information availability for families and informed consent-to-care to improve older adults’ quality of life and reduce care giver burden. Therefore, the following implications are suggested: evidence-based policy-making for appropriate use of antipsychotics and implementation of non-pharmacological and individualised interventions as the first option of available treatments; awareness and multidisciplinary collaboration for caring older adults; and more research to better understand the impact of alternative-to-antipsychotics interventions on quality of life and the cost of providing care. To address behavioural and psychological symptoms of dementia, the following steps are required (a) an interdisciplinary curriculum, so that health professionals can form appropriate skills; (b) inter-professional meetings to increase awareness of non-pharmacological approaches; (c) discussion with older adults and their families to explain the rationale for using antipsychotics to assure consent-to-care and (d) restructuring of the delivery of care for more person-centred approaches. Conclusion Increasing awareness of family physicians about the appropriate use of antipsychotics and effectiveness of alternative-to-antipsychotics strategies to treat behavioural and psychological symptoms of dementia may influence quality of life of older individuals with dementia. |
