N.E.S.T. Approach: Dementia Practice Guidelines for Disturbing Behaviors

A nest is a carefully crafted place that provides structure, safety, warmth, and caring. This guide was created with these qualities in mind. Healthcare providers serving as behavior specialists for older adults with dementia should be encouraged to examine the Needs, Environment, Stimulation, and Techniques 'N.E.S.T.' used in the care of the individual with disturbing behaviors. With this newfound information the team can create an appropriate plan of care and a supportive nest for living an active, engaged life, despite memory loss.

This guide compiles the research evidence on psychosocial interventions tested on older adults with dementia to date, and directs future research by pointing out what needs to be evaluated to improve our practice.

With this guide, we are suggesting that a non-pharmacological approach should be attempted before psychoactive medications are prescribed. Psychosocial therapy does not have the negative side effects of powerful psychoactive medications and often changes the disturbing behaviors more quickly, thus leading to an immediate positive impact on quality of life for the older adult. While there are many unanswered questions that need additional research, this is an exciting new initiative for dementia care providers.