Sensory stimulation in dementia

doi:10.1136/bmj.326.7390.661

BMJ 2003;326:661 ( 22 March )

Letters

Sensory stimulation in dementia

Cause of behavioural and psychological symptoms of dementia needs to be established first

Bright light may not illuminate

Cause of behavioural and psychological symptoms of dementia needs to be established first

The first 150 words of the full text of this article appear below.

EDITOR $---$ Burns et al urge caution in prescribing neuroleptic drugs for agitation in dementia and advance the cause of psychosocialalternatives, citing good evidence in support of bright lightand aromatherapy.¹

A conceptual problem remains. It is analogous to reflex prescription of neuroleptics (although with less risk of side effects)to attempt standard psychosocial cures before assessing causesof the behaviour $---$ well beyond essential screening for physiologicalaetiology such as infections or drug interactions. For example,sleep disturbance in nursing homes is commonly caused by staffwaking residents up.² It would be ludicrous to start brightlight therapy without first assessing the behaviour of nightstaff.

Most incidents of aggression are not random but occur in personal care.³ It would be naive to apply some standard psychosocialtherapy without first observing and adjusting how personal careisimplemented.

Case specificity extends even to what causes behaviour to become "challenging" . . . [Full text of this article]

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Sensory stimulation in dementia: Alistair Burns, Jane Byrne, Clive Ballard, and Clive Holmes
BMJ 2002 325: 1312-1313. [Extract] [Full Text] [PDF]

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