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The BPSD PLUS Program: Efficacy of a novel person‐centred care approach to reduce neuropsychiatric symptoms in residents with dementia
Author(s) -
Mortby Moyra E.,
SargentCox Kerry,
Beattie Elizabeth,
Lautenschlager Nicola T.,
Doyle Colleen,
Anstey Kaarin J.
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.038866
Subject(s) - psychological intervention , dementia , medicine , intervention (counseling) , massage , physical therapy , nursing , family medicine , alternative medicine , pathology , disease
Background The availability of effective non‐pharmacological interventions to ameliorate discomfort of residents with neuropsychiatric symptoms (NPS) living in aged care remains a pressing sector need. The BPSD PLUS Program is a novel person‐centred care training and intervention program developed by the team to provide aged care staff with a structured approach to identify and manage NPS using non‐pharmacological interventions. This pilot and feasibility study evaluates the efficacy of the BPSD PLUS Program to reduce NPS amongst residents over 12 months. Method 77 residents (67% female; age range 67‐101) and 69 staff (79% female; age range 19‐63 years) from 3 sites of a non‐for‐profit care provider (includes dementia‐specific units) participated in the program. The Program’s unique “Buddy System” pairs each resident with a staff member who is responsible for completing all aspects of the program with/for their resident. Program components include a two day face‐to‐face staff training, monthly resident assessments and 15‐minute intervention sessions 3‐times a week using one of five non‐pharmacological interventions (meaningful and pleasant activities; reminiscence; music; gentle exercise; massage and touch). Primary outcome was reduction in NPS over time as measured by the Neuropsychiatric Inventory – Nursing Home (NPI‐NH) and assessed using mixed model estimates. Result Implementation of the BPSD PLUS Program over 12 months resulted in a significant reduction of NPI‐NH total scores over 12 months (β=‐1.07, 95% CI=‐1.62, ‐0.52), with a significant quadratic fixed effect (β=0.05, 95% CI=0.01, 0.09) indicating that the decline in scores slowed over the course of the trial. Similarly, significant fixed linear and quadratic effects were found in the unadjusted models for depression (linear β=‐0.77, 95% CI=‐1.35,‐1.20; quadratic β=0.05, 95% CI=0.01, 0.01), and apathy (linear β=‐0.84, 95% CI=‐1.33,‐0.35; quadratic β=0.05, 95% CI=0.01, 0.09). Further, irritability symptoms showed a significant decline across the trial (β=‐0.74, 95% CI=‐1.32, ‐0.16). Conclusion This pilot and feasibility study demonstrates the efficacy of the novel BPSD PLUS Program to significantly reduce NPS in residents living in aged care. Evidence‐based training and interventions programs such as the BPSD PLUS Program provide staff with improved skills and knowledge to improve the quality of person‐cantered care provided and manage the clinical consequences of NPS in dementia care.