• 2019 GAPNA Pharmacology Conference: Contemporary Pharmacology and Prescribing in Older AdultsJoin us at the 2019 GAPNA Pharmacology Conference:
    Contemporary Pharmacology and Prescribing in Older Adults

    March 28-30, 2019, Chicago Hilton, Chicago, IL.

    Earn up to 11.5 CNE hours.

     

    Find out more about it and REGISTER today!

  • AwardCall for Excellence Award Nominations

    The awards are: Emerging Chapter Award, Established Chapter Excellence Award, Special Interest Group Excellence Award, Excellence in Clinical Practice Award, Excellence in Community Service Award, Excellence in Education Award, Excellence in Leadership Award, and Excellence in Research Award.

    The nominations are tallied in July and the winners are announced every year during the Awards Celebration at the GAPNA Annual Conference.

    Now is the time to nominate a colleague or yourself - DEADLINE is June 1, 2018.

    Get started... nominate today!

  • W A N T E D   G A P N A   L E A D E R S!
    Call for Nominations!

    Have you ever considered stepping forward, accepting the challenge and volunteering for a position on the 2019 National Board of Directors? Register online NOW by April 1, 2019!

    Step Up - NOW is the Time! Register Here>

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

    "Keynote Address - Health Policy: APRNs Working to the Full Extent of the Law"

    (session captured at the GAPNA 2018 Annual Conference)


    For March/April 2019 - Get Your Free CNE Now!

  • Poster Presentation

       

    This 22-module curriculum provides a basic knowledge base for Nurse Practitioners who looking to advance their expertise in caring for patients with dementia.
     

    FREE to GAPNA members until September 1, 2019

  • GAPNA Exchange

       

    GAPNA Exchange is a private, secure community for members to share ideas, ask questions, lend expertise, and network with peers.

    It features both an Open Forum discussion area along with smaller, segmented communities.

    Interact with GAPNA members wherever and whenever!

    Go to GAPNA Exchange

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!