Non-Pharmacological Alternatives Provide Better Treatment for Neuropsychiatric Symptoms of Dementia

The neuropsychiatric symptoms of dementia (NPS), which are characterized by psychological and behavioral problems, have a rather large presence within nursing homes as about 60% of the elderly individuals living in long term care have been diagnosed with dementia. The majority of the individuals of this group will go on to develop NPS at some point of their illness. Dementia is a chronic brain syndrome that affects a person’s brain function so that their emotional behavior, cognitive skills, memory, and speech are slowly corroded. Most dementia types are degenerative and cannot be reversed. However, even though the effects of dementia cannot be reversed, they can be slowed or treated through two different methods: psychotropic medications or non-pharmacological alternatives. In 2012, JAMDA conducted a study examining the effect of non-pharmacological alternatives as a means of treatment for dementia in comparison with the use of psychotropic medications within long term care facilities.

The guidelines associated for neuropsychiatric symptoms of dementia often strongly recommend the use of non-pharmacological interventions to treat elderly patients, some of which include but are not limited to: mental health consultation and treatment planning, staff training in NPS management strategies, recreational activities, music therapy, exercise, and other forms of sensory stimulation. However, some skilled nursing facilities rely instead on the use of psychotropic medications in order to subdue, or chemically restrain their patients. When psychotropics are combined with other drugs such as benzodiazepines, antipsychotics, or other sedatives, all of which are commonly used to treat NPS, polypharmacy can occur.

Chemical restraints are unjustly used in nursing facilities where understaffing and lack of correctly trained staff is a prevalent problem. The study found that by increasing the number of nursing staff available and ensuring that the staff is properly trained, the facility is able to better process the many demands that long term care staff must fulfill in order to provide sufficient care to their patients. This further opens up the amount of time that staff can engage in non-pharmacological activities that may help reduce NPS in dementia patients. There was evidence that pointed to the idea that NPS was further aggravated by unmet needs, and thus residents would use the symptoms as an expression to relieve needs such as uncomfortable sensations and pain, and a reduced threshold to stress. Chemical restraints do nothing to solve the needs of the elderly; instead, it takes away their ability to even express discomfort or pain.


There are adverse effects that can be seen in relation to the use of antipsychotic medications, such as cerebrovascular accidents that can worsen symptoms and a patient’s brain condition, and an increased risk of “>death. The use of chemical restraints violates an elderly patient’s rights, as the incorrect use of drugs can limit their ability to freely move their body through their own will. No one should ever have to lose the ability to express themselves, especially for the convenience of those who are employed to provide care and attention. If you believe that your loved one is currently in a situation where chemical restraints are used, or abuse is distributed in any other manner, please contact us. Our team of nursing abuse litigation experts found at the Law Offices of Ben Yeroushalmi can help guide you on what is the next best step to take to best protect your loved ones.