Developing a Non-Pharmacological Intervention Programme for Wandering in People with Dementia: Recommendations for Healthcare Providers in Nursing Homes

Background: Wandering among people with dementia (PwD) is associated with a high risk of injury and death. The stigma of dementia prevents Chinese dementia families from seeking information and support earlier, which increases the demand for long-term care facilities. Despite universal recognition o...

Full description

Bibliographic Details
Main Authors: Jing Wang, Ge Zhang, Min Min, Ying Xing, Hongli Chen, Cheng Li, Caifu Li, Hanhan Zhou, Xianwen Li
Format: Article
Language:English
Published: MDPI AG 2022-09-01
Series:Brain Sciences
Subjects:
Online Access:https://www.mdpi.com/2076-3425/12/10/1321
_version_ 1797474761698181120
author Jing Wang
Ge Zhang
Min Min
Ying Xing
Hongli Chen
Cheng Li
Caifu Li
Hanhan Zhou
Xianwen Li
author_facet Jing Wang
Ge Zhang
Min Min
Ying Xing
Hongli Chen
Cheng Li
Caifu Li
Hanhan Zhou
Xianwen Li
author_sort Jing Wang
collection DOAJ
description Background: Wandering among people with dementia (PwD) is associated with a high risk of injury and death. The stigma of dementia prevents Chinese dementia families from seeking information and support earlier, which increases the demand for long-term care facilities. Despite universal recognition of the importance of care facilities, healthcare providers in care facilities still lack the relevant nursing knowledge and skills, including non-pharmacological interventions (NPIs) that have been proven to be effective in preventing wandering. Systematic and culturally appropriate NPI programmes for healthcare providers to manage wandering among PwD in long-term care facilities are still lacking. We aimed to develop an evidence-based and culturally appropriate NPI programme for wandering in PwD to guide healthcare providers in nursing homes to prevent wandering and its adverse outcomes. Methods: The NPI programme was developed according to the framework of the Belgian Centre for Evidence-Based Medicine (CEBAM). We, (1) performed a systematic literature search to summarize the available evidence, (2) developed evidence-based recommendations for the NPI programme based on the existing evidence, and (3) carried out a validation process to revise the content of the recommendations and to determine the grades of recommendations, including group meetings with experts and a survey for end-users. Results: Based on 22 publications and validation from 7 experts and 76 end users, we developed 21 recommendations covering 4 domains: (1) caregiver education, (2) preventing excessive wandering, (3) promoting safe walking, and (4) preventing people with dementia from going missing. We created almost all recommendations of the four domains with accompanying levels of evidence and grades of recommendations. Conclusions: By combining the evidence with expert and end-user opinions, a comprehensive NPI programme was developed to support institutional healthcare providers to prevent wandering and its adverse outcomes. The benefits of this programme are currently being tested.
first_indexed 2024-03-09T20:34:42Z
format Article
id doaj.art-202a9ff7db4f4f3b8a68aa1f599512da
institution Directory Open Access Journal
issn 2076-3425
language English
last_indexed 2024-03-09T20:34:42Z
publishDate 2022-09-01
publisher MDPI AG
record_format Article
series Brain Sciences
spelling doaj.art-202a9ff7db4f4f3b8a68aa1f599512da2023-11-23T23:13:32ZengMDPI AGBrain Sciences2076-34252022-09-011210132110.3390/brainsci12101321Developing a Non-Pharmacological Intervention Programme for Wandering in People with Dementia: Recommendations for Healthcare Providers in Nursing HomesJing Wang0Ge Zhang1Min Min2Ying Xing3Hongli Chen4Cheng Li5Caifu Li6Hanhan Zhou7Xianwen Li8School of Nursing, Nanjing Medical University, Nanjing 210000, ChinaThe Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210000, ChinaLandsea Long-Term Care Facility, Nanjing 210000, ChinaSchool of Nursing, Nanjing Medical University, Nanjing 210000, ChinaSchool of Nursing, Nanjing Medical University, Nanjing 210000, ChinaSchool of Nursing, Nanjing Medical University, Nanjing 210000, ChinaSchool of Medicine, Lishui University, Lishui 323000, ChinaClinical and Nursing Training Center, Jiangsu Health Vocational College, Nanjing 210000, ChinaSchool of Nursing, Nanjing Medical University, Nanjing 210000, ChinaBackground: Wandering among people with dementia (PwD) is associated with a high risk of injury and death. The stigma of dementia prevents Chinese dementia families from seeking information and support earlier, which increases the demand for long-term care facilities. Despite universal recognition of the importance of care facilities, healthcare providers in care facilities still lack the relevant nursing knowledge and skills, including non-pharmacological interventions (NPIs) that have been proven to be effective in preventing wandering. Systematic and culturally appropriate NPI programmes for healthcare providers to manage wandering among PwD in long-term care facilities are still lacking. We aimed to develop an evidence-based and culturally appropriate NPI programme for wandering in PwD to guide healthcare providers in nursing homes to prevent wandering and its adverse outcomes. Methods: The NPI programme was developed according to the framework of the Belgian Centre for Evidence-Based Medicine (CEBAM). We, (1) performed a systematic literature search to summarize the available evidence, (2) developed evidence-based recommendations for the NPI programme based on the existing evidence, and (3) carried out a validation process to revise the content of the recommendations and to determine the grades of recommendations, including group meetings with experts and a survey for end-users. Results: Based on 22 publications and validation from 7 experts and 76 end users, we developed 21 recommendations covering 4 domains: (1) caregiver education, (2) preventing excessive wandering, (3) promoting safe walking, and (4) preventing people with dementia from going missing. We created almost all recommendations of the four domains with accompanying levels of evidence and grades of recommendations. Conclusions: By combining the evidence with expert and end-user opinions, a comprehensive NPI programme was developed to support institutional healthcare providers to prevent wandering and its adverse outcomes. The benefits of this programme are currently being tested.https://www.mdpi.com/2076-3425/12/10/1321non-pharmacological interventionsprogrammedementiawanderingelderly care
spellingShingle Jing Wang
Ge Zhang
Min Min
Ying Xing
Hongli Chen
Cheng Li
Caifu Li
Hanhan Zhou
Xianwen Li
Developing a Non-Pharmacological Intervention Programme for Wandering in People with Dementia: Recommendations for Healthcare Providers in Nursing Homes
Brain Sciences
non-pharmacological interventions
programme
dementia
wandering
elderly care
title Developing a Non-Pharmacological Intervention Programme for Wandering in People with Dementia: Recommendations for Healthcare Providers in Nursing Homes
title_full Developing a Non-Pharmacological Intervention Programme for Wandering in People with Dementia: Recommendations for Healthcare Providers in Nursing Homes
title_fullStr Developing a Non-Pharmacological Intervention Programme for Wandering in People with Dementia: Recommendations for Healthcare Providers in Nursing Homes
title_full_unstemmed Developing a Non-Pharmacological Intervention Programme for Wandering in People with Dementia: Recommendations for Healthcare Providers in Nursing Homes
title_short Developing a Non-Pharmacological Intervention Programme for Wandering in People with Dementia: Recommendations for Healthcare Providers in Nursing Homes
title_sort developing a non pharmacological intervention programme for wandering in people with dementia recommendations for healthcare providers in nursing homes
topic non-pharmacological interventions
programme
dementia
wandering
elderly care
url https://www.mdpi.com/2076-3425/12/10/1321
work_keys_str_mv AT jingwang developinganonpharmacologicalinterventionprogrammeforwanderinginpeoplewithdementiarecommendationsforhealthcareprovidersinnursinghomes
AT gezhang developinganonpharmacologicalinterventionprogrammeforwanderinginpeoplewithdementiarecommendationsforhealthcareprovidersinnursinghomes
AT minmin developinganonpharmacologicalinterventionprogrammeforwanderinginpeoplewithdementiarecommendationsforhealthcareprovidersinnursinghomes
AT yingxing developinganonpharmacologicalinterventionprogrammeforwanderinginpeoplewithdementiarecommendationsforhealthcareprovidersinnursinghomes
AT honglichen developinganonpharmacologicalinterventionprogrammeforwanderinginpeoplewithdementiarecommendationsforhealthcareprovidersinnursinghomes
AT chengli developinganonpharmacologicalinterventionprogrammeforwanderinginpeoplewithdementiarecommendationsforhealthcareprovidersinnursinghomes
AT caifuli developinganonpharmacologicalinterventionprogrammeforwanderinginpeoplewithdementiarecommendationsforhealthcareprovidersinnursinghomes
AT hanhanzhou developinganonpharmacologicalinterventionprogrammeforwanderinginpeoplewithdementiarecommendationsforhealthcareprovidersinnursinghomes
AT xianwenli developinganonpharmacologicalinterventionprogrammeforwanderinginpeoplewithdementiarecommendationsforhealthcareprovidersinnursinghomes