This Toolkit was prepared for the Commonwealth Fund in collaboration with the Hartford Foundation. Ann Kolanowski, RN, Ph.D., and Kimberly Van Haitsma, Ph.D., served as the coordinators of the expert panel who compiled much of the information contained in the toolkit.
This Toolkit-Promoting positive behavioral health: A nonpharmacologic toolkit for senior living communities-contains resources to help staff in senior living communities promote nonpharmacologic behavioral health strategies to address behavioral and psychological symptoms of dementia (BPSD) behaviors that frequently occur in long-term care residential settings, especially among residents with dementia.
Many terms may be used to describe BPSD, such as agitation, aggression, behavioral expressions of dementia etc. Further, numerous terms may be used to describe nonpharmacological approaches for responding to these symptoms such as treatment, intervention, approach. The language that describes symptoms and approaches reflects differences in how symptoms and approaches are conceptualized. This Toolkit uses the terms BPSD and nonpharmacological approaches because these terms have wide acceptance, are person-centered, and are understood by most nursing home staff.
Non-pharmacological approaches (NPA) are a first priority for responding to the behavioral and psychological symptoms of dementia (BPSD) due to the high risks and limited effectiveness of antipsychotic medications for treating BPSD1. As a result, there is an urgent need to equip nursing home providers with readily accessible tools for identifying and implementing NPA.
Based on this critical need, the goal of our project was to convene a national, interdisciplinary group of geriatric behavioral experts who would collaborate on the development of a behavioral health toolbox for staff. This toolbox was conceptualized as a compendium of peer-reviewed/expert-endorsed existing resources that would assist staff in the implementation of non-pharmacological strategies for BPSD. Further, the toolbox would be readily accessible and include: staff educational programs for non-pharmacological approaches; methods for assessing behaviors; person-centered interventions; and system-wide methods for integrating interventions into the culture of care.
The Toolkit contains resources relevant to any type of senior living community, including nursing homes, assisted living facilities, and continuing care retirement communities. There is information targeted to professional and paraprofessional staff in all departments, including the executive director, administrators, department supervisors; nurses, physicians, mental health professionals, social workers, and recreational therapists.
The Toolkit uses a comprehensive framework that consists of explicating a person-centered philosophical stance, and an overview of evidence-based resources addressing the following major areas: