Living with Dementia and Cognitive Disorders: Beyond Pharmacology

A recent study [1], which involved interviews with an array of nursing home staff, from CEOs to nursing aids at five Israeli nursing homes, revealed a common complaint: residents’ aggressive behavior. Routine practice in morning care involved nursing aids waking residents starting at 5:30 am in order to shower, dress, and seat them in the dining room by 8:00 am. The staff noted aggression by residents during early morning care, but they did not recognize the association between the residents’ aggressiveness and the staff’s morning care practices. This is, but one example of insufficiently informed care practices and systems that lead to the very problem that all agree needs to be remedied. This chapter (1) summarizes the behavioral challenges of persons with dementia, (2) describes the main conceptual and practical ways to address them without resorting to pharmacological means, and (3) discusses systemic and structural changes needed to improve care-recipients’ and caregivers’ well-being.