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Management of dementia-related agitation: between the devil and the deep blue sea
  1. Michael J Passmore
  1. Department of Psychiatry, University of British Columbia, Mount St. Joseph Hospital, Ward 1 South, 3080 Prince Edward St, Vancouver, British Columbia, Canada V5T 3N4; passmoremd@gmail.com

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What is already known on this topic?

Dementia-related agitation is a common and costly condition that is distressing, debilitating, often dangerous and usually difficult to treat in a safe and reliable manner.1 Clinicians are caught between the ‘devil’ of medications with unfavourable risk–benefit profiles2 and the ‘deep blue sea’ of non-pharmacological interventions perceived as impractical and lacking in evidence for benefit.3 Before opting for any intervention, it is essential to rule out underlying causes of agitation and then consider strategies such as environmental modification, sensory interventions and family involvement/support.

What does this paper add?

  • In care-home dementia residents, training paid caregivers in person-centred care, communication skills and dementia mapping (focusing on patient needs and with supervision of trained caregivers during implementation) significantly reduced agitation at implementation and for up to 6 months afterwards.

  • Group activities, sensory intervention and music therapy all prevented agitation during the intervention; sensory interventions also reduced clinically significant symptoms of agitation.

  • Aromatherapy, light therapy and home-like care do not reduce agitation.

Limitations

  • The complex and dynamic nature of dementia-related agitation, along with …

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