Abstract
A high proportion of nursing home residents with dementia receive major tranquillisers for behavioural symptoms despite only modest benefits and serious side effects. Good practice guidelines recommend that psychological or environmental management options should be the first line approach. Interventions should be based on identifying triggers to behavioural problems and use of a 'tool box' approach that is tailored to the needs of each individual. The researchers provided a training programme exploring the philosophy and application of person-centred care; positive care planning; awareness of environmental design issues; active listening and communication skills; reminiscence techniques and involvement of family carers. The percentage of residents who were prescribed neuroleptics at the end of 12 months was less than half that in the control homes. Levels of agitation and episodes of aggressive behaviour did not increase in homes with reduced prescribing of neuroleptics. This demonstrates that, given appropriate learning opportunities, nurses can maintain a good standard of care without automatically resorting to medication to control behaviour.
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