A person-centered approach is key to managing common behaviors related to dementia, according to new guidance from the Alzheimer’s Association Dementia Care Provider Roundtable.

Almost all people with dementia will exhibit behavioral expressions in one or more forms, including mental health problems, sexual or social disinhibition, sleep disturbance, aggression and agitation. These behaviors should be seen as reactions of stress to the physical and social environment rather than dementia symptoms, say the authors, a group of 23 leaders from long-term and community-based care provider organizations. 

Addressing the distress that underlies these behaviors can lead to a better quality of life and prevent rapid decline in people with dementia. But non-pharmacologic, behavioral support approaches are not yet part of routine clinical and care practice, the authors contend.

“There is emerging concern that [these approaches] are not well understood by intended users, and that ‘person-centered’ practices are not always as person-centered as intended,” they write. 

The authors outline five practice areas with detailed examples of how to use this type of care as a first-line intervention: 

  • Having a foundational person-centered culture,
  • Conceptualizing behaviors as expressions and focusing on behavioral support,
  • Identifying antecedents and placing person-centeredness before protocols,
  • Modifying training to promote person-centered culture, and 
  • Valuing implementation flexibility. 

“It is hoped that the five areas of guidance … will ultimately lead to real provision of effective, person-centered care for behavioral expressions of dementia, regardless of the setting in which care is provided,” they conclude.

An article, “What Is Really Needed to Provide Effective, Person-Centered Care for Behavioral Expressions of Dementia? Guidance from The Alzheimer’s Association Dementia Care Provider Roundtable,” was published in JAMDA.