1 January 2004
National Guideline Clearinghouse
Gerontological Nursing Interventions Research Center (University of Iowa), Research Development and Dissemination Core
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DISEASE/CONDITION(S)

• Alzheimer disease
• Dementia
• Other chronic dementing illnesses (e.g., Pick's disease, Huntington disease, and Parkinson disease)

GUIDELINE CATEGORY
Management

CLINICAL SPECIALTY
Geriatrics
Neurology
Nursing
Psychiatry

INTENDED USERS
Advanced Practice Nurses
Nurses

GUIDELINE OBJECTIVE(S)
To discuss evidence-based non-pharmacologic interventions designed to decrease the frequency of agitated behaviors, thereby supporting functional ability and enhancing quality of life for persons experiencing Alzheimer Disease (AD) and other chronic dementing conditions

TARGET POPULATION
Institutionalized patients with Alzheimer disease or chronic dementing illnesses

INTERVENTIONS AND PRACTICES CONSIDERED

1. Patient screening using Mini-Mental State Examination
2. Assessment of patterns of agitated behavior using Cohen-Mansfield Agitation Inventory
3. General communication techniques including verbal and non-verbal techniques
4. Sensory enhancement/relaxation, such as massage and touch interventions, individualized music, white noise, sensory stimulation
5. Social contact including individualized social contact, pet therapy, one-to-one interaction, simulated interactions/family videos
6. Behavior therapy including differential reinforcement and stimulus control
7. Structured activities, such as recreational activities, outdoor walks, physical activities
8. Environmental interventions including access to wandering areas, natural/enhanced environment, reduced stimulation, light therapy

MAJOR OUTCOMES CONSIDERED

• Frequency and severity of agitated behaviors
• Quality of life for persons with dementia and their caregivers
• Functional ability

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