Effects of non-facilitated meaningful activities for people with dementia in long-term care facilities: A systematic review.
Cindy Jones, Fangli Liu, Jenny Murfield and 1 others
PMID 32571584WHAT IT FOUND
In dementia long-term care, non-facilitated music, dolls, PARO and plush toys showed mixed short-term effects.
Some reduced agitation or increased pleasure during activity, but lasting benefit was not established.
Key findings
01Only six controlled studies involving 628 older residents with dementia in long-term care were identified, and the activities and outcome measures varied widely.
02Simulated family presence and preferred music reduced physical agitation, while PARO increased verbal and visual engagement compared with a plush toy.
03No included study followed participants after the activity, and benefits were mostly observed while the activity was happening.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
Only six controlled studies were included, involving 628 older residents with dementia, so the evidence base is small. Five of the six studies had small sample sizes, and the largest study had 415 participants while the smallest had 20. The interventions, durations, frequencies, outcomes and measurement tools varied widely, so the review could not pool the results. No study followed participants after the activity ended, so sustained benefit is unknown. Several studies had unclear randomisation, possible baseline imbalance, incomplete outcome data, or unblinded or unclear outcome assessment. Only English-language studies and people aged 65 years and over were included. The findings may not apply to other languages or younger-onset dementia. Almost three-quarters of participants were female, so findings may not apply equally to men.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that non-facilitated activities reliably treat agitation or mood in dementia. The review included only six heterogeneous studies, found many null results, and reported benefits mostly during activity with no follow-up.