What Do We Know About Behavioral Crises in Dementia? A Systematic Review

Backhouse, Tamara, Camino, Julieta and Mioshi, Eneida (2018) What Do We Know About Behavioral Crises in Dementia? A Systematic Review. Journal of Alzheimer's Disease, 62 (1). pp. 99-113. ISSN 1387-2877

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Abstract

Background: Behavioral crises in dementia are represented by a wide variety of symptoms, regularly require external intervention from professionals, and are reported as a risk factor for hospital admission. Little is known about the factors that are associated with them. Aim: To determine the factors associated with dementia-related behavioral crises. Methods: We searched MEDLINE, CINAHL, PsycINFO, EMBASE and AMED databases. An additional lateral search including reference lists was conducted. Two researchers screened all records for potential eligibility. Narrative synthesis was used to bring together the findings. Results: Out of the 5544 records identified, 24 articles (18 distinct studies) met the eligibility criteria. Aggression and agitation were the most common behaviors present at crises. Delusions, wandering / absconding and hallucinations were also key behaviors contributing to crises. Behavioral crises predominantly happened in the severe stages of dementia (according to MMSE scores), in people with dementia residing in their own homes and in long-term care, and were the catalyst for admissions to psychiatric inpatient settings, specialist-care units, long-term care settings, or for referrals to psychiatric community services. Lack of consistency in assessment of behavior, and management of agitation/aggression in dementia crises were evident. Conclusion: Interventions to reduce the likelihood of people with dementia-related behaviors reaching crisis point need to focus on both family and care home settings and incorporate aggression and agitation management. Future research should focus on determining the factors that could be addressed to prevent behavioral crises and the interventions and models of care that may help to prevent crises.

Item Type: Article
Uncontrolled Keywords: dementia,behavior,crisis intervention,institutionalization,hospitalization,behavioral symptoms
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Faculty of Medicine and Health Sciences > School of Health Sciences
Depositing User: Pure Connector
Date Deposited: 21 Nov 2017 06:05
Last Modified: 22 Apr 2020 23:45
URI: https://ueaeprints.uea.ac.uk/id/eprint/65508
DOI: 10.3233/JAD-170679

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