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

Jing Wang; Ge Zhang; Min Min; Ying Xing; Hongli Chen; Cheng Li; Caifu Li; Hanhan Zhou; Xianwen Li

doi:10.3390/brainsci12101321

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

Brain Sci. 2022 Sep 29;12(10):1321. doi: 10.3390/brainsci12101321.

Authors

Jing Wang¹, Ge Zhang², Min Min³, Ying Xing¹, Hongli Chen¹, Cheng Li¹, Caifu Li⁴, Hanhan Zhou⁵, Xianwen Li¹

Affiliations

¹ School of Nursing, Nanjing Medical University, Nanjing 210000, China.
² The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210000, China.
³ Landsea Long-Term Care Facility, Nanjing 210000, China.
⁴ School of Medicine, Lishui University, Lishui 323000, China.
⁵ Clinical and Nursing Training Center, Jiangsu Health Vocational College, Nanjing 210000, China.

Abstract

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.

Keywords: dementia; elderly care; non-pharmacological interventions; programme; wandering.

Grants and funding

This article was funded by Jiangsu Commission of Health Foundation under Grant No.Z2020028, Zhejiang Provincial Natural Science Foundation of China under Grant No.LY19G030001, Research Project of Philosophy and Social Sciences in Jiangsu Universities under Grant No.2022SJYB0298, Jiangsu Health Vocational College Foundation under Grant No.JKB201907, and Connotation Construction Project of Nanjing Medical University for Priority Academic of Nursing Science (2022-12). The funding agency had no role in the design, data collection, analysis or interpretation of the study.