The effects of emotion-oriented approaches in the care for persons suffering from dementia: A review of the literature

Objective. This article presents an overview of the results of intervention studies in various emotion-oriented approaches in the care for people suff ering from dementia. Recommendations are made with regard to clinical pract ice and future research. Data sources. We searched for references (1990-99) in several bibliographic al databases, i.e. Medline, PsycLit, Embase, Sociofile and Current Contents . The terms 'dementia' and 'Alzheimer's disease' were linked separately to the search terms: emotion-oriented, validation (therapy), sensory integrati on/sensory stimulation/snoezelen, simulated presence therapy and reminiscen ce (therapy)/life-review. Based on references in the articles found, other publications were traced. Study selection. We started from the 'emotion-oriented' approaches used in 24-hour care distinguished by the American Psychiatric Association (1997) i .e. validation, sensory stimulation/integration, simulated presence therapy and reminiscence. We selected research articles that describe intervention , design, measuring instruments and results. Data extraction. The articles were analyzed with regard to research group, setting, design, effect variables, intervention, measuring instruments, sta tistical analyses and results. Data synthesis. It is shown that mainly positive results (including increas ed social interaction and decrease of behavior problems) are achieved with these emotion-oriented approaches. Unfortunately many studies have methodol ogical limitations and are done independently, which makes comparison diffi cult. Conclusions. Despite the limited cogency of the studies we traced, the resu lts are promising. Emotion-oriented care approaches offer the opportunity t o tailor the care to the individual needs of dementing elderly and can be c omplemented with other psychosocial approaches (e.g. psychomotor therapy an d music therapy) when necessary. The challenge for the care sector is to de velop guidelines to determine which approach should be applied to whom and when. Scientific research can contribute by examining which emotion-oriente d approaches, possibly in combination with each other or with psychosocial therapies, effect an increase in the well-being and improve functioning in which patients. Copyright (C) 2000 John Wiley & Sons, Ltd.