• 2020 GAPNA Pharmacology Conference: Contemporary Pharmacology and Prescribing in Older AdultsJoin us at the 2020 GAPNA Pharmacology Conference:
    Contemporary Pharmacology and Prescribing in Older Adults

    April 14-18, 2020, Honolulu, HI.

    Earn up to 18 CNE hours.

     

    Find out more about it and REGISTER today!

  • 2019 Senior Report Senior Report: Older Americans have more options for home care, but still struggling.

    The United Health Foundation has released results of a sweeping new study benchmarking the health of older adults. The America's Health Rankings® Senior Report was created in partnership with GAPNA to improve the health of America's seniors.

    The data will help advanced practice nurses and other providers deliver quality care.

    Find out about it!

  • AwardNew for GAPNA members: MCM Education

    GAPNA has partnered with a MCM Education to offer an ongoing series of CNE programs available to GAPNA members. "Diagnosing and Managing Parkinson’s Disease in Older Adults," is the latest program offered.

    Parkinson’s disease (PD) is characterized by both motor and nonmotor symptoms. It is diagnosed based on the presence of two of four motor symptoms including rest tremor, bradykinesia, rigidity, and gait imbalance...

    Find out about it!

  • FREE continuing education credit is available for the following session:

    "Dementia Management Update"

    (session captured at the GAPNA 2018 Annual Conference)


    For September/October 2019 - Get Your Free CNE Now!

Treatment of Psychosis

Nonpharmacological Treatment of Psychosis in Older Adults

A therapeutic relationship built on trust and mutual respect with the advanced practice registered nurse is one of the most important interventions for working with older adults.

For individuals presenting with signs/symptoms of possible psychoses, addressing triggers and potential underlying physical causes is the first step in formulating the most accurate diagnosis.

Once a diagnosis is determined, it is imperative that an individualized, person-centered plan of care is developed. Individualization includes the person’s values, goals, wishes, cultural identity, and diagnosis. Using both nonpharmacologic and pharmacologic interventions is prudent.

Nonpharmacological interventions (NPIs) are those that do not involve drugs or medications of any type, including oral over-the-counter and herbal remedies, and are psycho-social-spiritual in nature. Agitation, aggression, disruption, shadowing, depression, and repetitive behaviors can be improved with use of NPIs (Brodaty & Arasaratnam, 2012).

Promoting mild daily physical activity, appropriate nutritional intake, music therapy, aromatherapy, reminiscence and life review, meaningful individualized activities (independently or in a group setting), and a consistent/routine schedule can decrease psychotic symptoms (Blevins, 2018; Chen et al., 2014; de Oliveira et al., 2015; Gerdner, 2012).

NPIs are generally the first approach to psychosis unless the individual is a danger to self or others. In many cases, a combination of NPIs with pharmacological intervention are best for the individual.

Linda J. Keilman, DNP, GNP-BC, FAANP
keilman@msu.edu


References

Blevins, C.L. (2018). Optimizing care for older adults with dementia-associated psychosis. The Journal for Nurse Practitioners, 14(3), 178-182.

Brodaty, H., & Arasaratnam, C. (2012). Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. American Journal of Psychiatry, 169(9), 946-953.

Chen, R., Liu, C., Lin, M., Peng, L., Chen, L., Liu, L., & Chen, L. (2014). Non-pharmacological treatment reducing not only behavioral symptoms, but also psychotic symptoms of older adults with dementia: A prospective cohort study in Taiwan. Geriatrics & Gerontology International, 14(2), 440-446

de Oliveira, A.M., Radanovic, M., de Mello, P.C., Buchair, P.C., Vizzotto, A.D., Celestino, D. L., … Forlenza, O.V. (2015). Nonpharmacological interventions to reduce behavioral and psychological symptoms of dementia: A systematic review. BioMed Research International. doi:10.1155/2015/218980

Gerdner, L. A. (2012). Individualized music for dementia: Evolution and application of evidence-based protocol. World Journal of Psychiatry, 2(2), 26-32.

Plan your trip to the nation’s capital during the GAPNA Annual Conference, September 26-29, 2018 by checking out all the things to do, places to eat, and ways to have fun.

Find out about it!