• CoronaCoronavirus (COVID-19) Resources

    In an effort to support our members with the most updated information on COVID-19 we developed this resource page to easily access current CDC information and other resources to assist you professionally and personally.

    We will continue to update this page with more information as it becomes available and welcome your input as we navigate through this situation. As health care professionals it is our job to educate our patients and families on prevention and the what to do if someone is symptomatic.

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  • 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, 2020.

    Get started... nominate today!

  • Meet the Candidates for the 2020-2021 BOD!
    Voting begins May 4 - 29, 2020!

    Please take a moment to read about this year’s candidates and why they feel they should be chosen for the position noted.

    MEET THE CANDIDATES IN ADVANCE OF YOUR VOTE   >

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!