TY - JOUR

T1 - Ecopsychosocial Interventions in Cognitive Decline and Dementia

T2 - A New Terminology and a New Paradigm

AU - Zeisel, John

AU - Reisberg, Barry

AU - Whitehouse, Peter

AU - Woods, Robert

AU - Verheul, Ad

N1 - Dr Barry Reisberg’s work on this manuscript was supported in part by the US Department of Health and Human Services (DHHS) grant P30 AG08051 from the National Institute on Aging of the US National Institutes of Health, by the Fisher Center for Alzheimer’s Research Foundation, by the Hagedorn Fund, by the Louis J. Kay and June E. Kay Foundation, by the Stringer Foundation, and by donations from Dr Felix Glaubach and Miriam Glaubach. Dr Peter Whitehouse’s work on this manuscript was supported in part by the Spitz Family Foundation and the Shigeo and Megumi Takayama Foundation. Dr John Zeisel’s work on this manuscript has been partially supported by grants from the National Institute on Aging, including Life’s a Stage (5R44AG035404-03) and Hearthside Book Club (5R44AG039907-03).

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Dementia is a major medical and social scourge. Neither pharmacological nor nonpharmacological interventions and treatments have received sufficient funding to be meaningful in combatting this tsunami. Because the term—‘‘nonpharmacological’’—refers to what these interventions are not, rather than what they are, nonpharmacological treatments face a special set of challenges to be recognized, accepted, funded, and implemented. In some ways, the current situation is analogous to using the term ‘‘nonhate’’ to mean ‘‘love.’’ This article presents a carefully reasoned argument for using the terminology ‘‘ecopsychosocial’’ to describe the full range of approaches and interventions that fall into this category. These include interventions such as educational efforts with care partners, social support programs for individuals with various levels of dementia, efforts to improve community awareness of dementia, an intergenerational school where persons with dementia teach young children, and the design of residential and community settings that improve functioning and can reduce behavioral symptoms of dementia. The proposed terminologyrelates to the nature of the interventions themselves, rather than their outcomes, and reflects the broadest range of interventions possible under the present rubric—nonpharmacological. The goal of this new label is to be better able to compare interventions and their outcomes and to be able to see the connections between data sets presently not seen as fitting together, therebyencouraging greater focus on developing new ecopsychosocial interventions and approaches that can improve the lives of those with dementia, their care partners, and the broader society.

AB - Dementia is a major medical and social scourge. Neither pharmacological nor nonpharmacological interventions and treatments have received sufficient funding to be meaningful in combatting this tsunami. Because the term—‘‘nonpharmacological’’—refers to what these interventions are not, rather than what they are, nonpharmacological treatments face a special set of challenges to be recognized, accepted, funded, and implemented. In some ways, the current situation is analogous to using the term ‘‘nonhate’’ to mean ‘‘love.’’ This article presents a carefully reasoned argument for using the terminology ‘‘ecopsychosocial’’ to describe the full range of approaches and interventions that fall into this category. These include interventions such as educational efforts with care partners, social support programs for individuals with various levels of dementia, efforts to improve community awareness of dementia, an intergenerational school where persons with dementia teach young children, and the design of residential and community settings that improve functioning and can reduce behavioral symptoms of dementia. The proposed terminologyrelates to the nature of the interventions themselves, rather than their outcomes, and reflects the broadest range of interventions possible under the present rubric—nonpharmacological. The goal of this new label is to be better able to compare interventions and their outcomes and to be able to see the connections between data sets presently not seen as fitting together, therebyencouraging greater focus on developing new ecopsychosocial interventions and approaches that can improve the lives of those with dementia, their care partners, and the broader society.

KW - Nonpharmacological

KW - Alzheimer's

KW - Dementia

KW - Terminololgy

KW - Ecopsychosocial

U2 - 10.1177/1533317516650806

DO - 10.1177/1533317516650806

M3 - Article

VL - 31

SP - 502

EP - 507

JO - American Journal of Alzheimer's Disease and Other Dementias

JF - American Journal of Alzheimer's Disease and Other Dementias

SN - 1533-3175

IS - 6

ER -