Implementing Non-Pharmacological interventions for dementia in long-term care: A scoping review

Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent among residents in long-term care (LTC) and contribute to poor quality of life and increased caregiver burden. Non-pharmacological interventions (NPIs) are recommended as first-line approaches, but their implementation is often limited by workforce shortages, inconsistent protocols, and lack of staff preparation. This scoping review mapped NPI characteristics, reported outcomes, and key implementation challenges used to address BPSD in LTC. Thirty-two studies met criteria and were included, encompassing music therapy, reminiscence therapy, exercise programs, assistive technology, multimodal interventions, and emerging therapies. Intervention characteristics such as personalization and cultural tailoring were associated with improved engagement and emotional responsiveness. Outcomes included reductions in agitation, anxiety, and mood disturbances, though effects varied across settings and modalities. Common challenges included staffing limitations, lack of standardized protocols, and ethical considerations. These findings point to opportunities for more structured, scalable NPI models and highlight the need for future research that incorporates resident and staff perspectives to support sustainable dementia care practices.