Managing behavioural and psychological symptoms in people with dementia and their carers living at home - A mixed methods evidence synthesis

Two-thirds of people with dementia live at home and many experience non-cognitive behavioural and psychological symptoms of dementia (BPSD) or distressing behaviour. This paper reports findings from a systematic review of the literature about this subject. Its unique feature is that our focus was on older people with dementia living in their own homes and not care homes. We reviewed qualitative and quantitative evidence concerning non-pharmacological interventions to minimise BPSD and improve outcomes for people with dementia and their family carers. We then evaluated the evidence from the perspectives of people with dementia, family carers (including people from Black and Minority Ethnic groups), service providers and commissioners. We employed a two stage co-design for an indepth systematic review integrated with focus groups and interviews with stakeholders . We retrieved around 16,000 records from searching electronic databases (January 2000-May 2014) and lateral searches, and identified relevant qualitative (over 50) and quantitative (over 60) studies targeting community dwelling people with dementia and carers for inclusion in the evidence synthesis. This paper presents findings from three sources of data: 1) What is the evidence on the effectiveness of different types of interventions on managing BPSD? 2) What are the perspectives of people with dementia and carers on this subject? 3) What are the key concerns of stakeholders? We will discuss methodological challenges and stakeholders’ views and will make recommendations for service providers and researchers.