BPSD

Aim. To conduct a best-evidence review of non-pharmacological interventions for resistance-to-care behaviours of nursing home residents with dementia in a personal care context.
Background. Resistance to care is a major source of staff burnout in nursing homes and it is also a safety issue for the staff.
Design. Best-evidence review.
Data Sources. We searched for non-pharmacological intervention studies published from 1990 to 2012, written in English, using the following data sources: CINAHL, MEDLINE, Embase, PsycINFO, Cochrane Clinical Trials, SCOPUS, ProQuest (dissertations), Web of Knowledge, Mosby’s Nursing Consult, and Health Source: Nursing/Academic Edition. The search was performed using the following terms: resist, reject, resistance, resistiveness, refusal, agitation, disruptive behaviour, dementia, care, and nursing care.
Review Methods. The search identified 19 intervention studies that examined the effects of interventions to reduce the resistance-to-care behaviours of nursing home residents with dementia in a personal care context. These 19 papers met the quality assessment requirements of the critical appraisal criteria for experimental studies, which was published by the Joanna Briggs Institute.
Results. Music interventions, such as prerecorded music played to a group or playing a resident’s preferred music, during his or her personal care, reduced resistance-to-care behaviours. Resistance-to-care behaviours also were reduced by interventions related to bathing and morning care that focused on person-centred care.
Conclusion. Non-pharmacological interventions are options to consider to reduce resistance-to-care behaviours in elderly with dementia even though the evidence level is low, given the lack of alternatives. More randomised controlled trials are recommended to confirm the effects of non-pharmacological interventions.