Nonpharmacological interventions have been used with persons with dementia for multiple purposes, including improving cognitive function, enhancing function in the performance of activities of daily living, improving mood and affect, reducing behavioral problems, and enhancing the sense of self. These interventions are based on several theoretical frameworks, including cognitive, behavioral, Maslow’s hierarchy of needs, Eriksonian theory and others. Several specific interventions have been described in the literature for each of these purposes and most of the theoretical frameworks.
How does a practitioner utilize this myriad of approaches? Several questions need to be raised:
1) Does the framework apply to specific case?
2) Is the intervention efficacious?
3) Does it match the older person in terms of:
Need,
Cognitive level,
Sensory abilities, and
Interests and preferences?
4) What are the costs (monetary and other)/feasibility of the intervention and how does it relate to other options?
Professionals in the field of dementia need to be aware of the range of options for treatments. We also need to be aware of the limitations of this field in terms of knowledge that needs to be gathered, such as what is the active ingredient of these interventions. The societal limitations on the growth of knowledge in this field and on the practice of these interventions will also be discussed.
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