Incorporating environment enrichment strategies to assist in the management of behavioural and psychological symptoms of dementia (BPSD): A review of the evidence.

Miss Bridget Hoole1, Miss Rose Goonan1

1The Royal Melbourne Hospital, Parkville, Australia


Aim: To review for evidence-based approaches to the management of BPSD in a secure, dementia specific ward in a major metropolitan hospital using environmental enrichment strategies.

Method:  A literature review was completed.  Surveys were also completed with staff working on the dementia-specific ward regarding their perceptions of the current ward environment.  Survey data was collated and analysed descriptively. Potential recommendations were made to enhance the ward environment and minimise BPSD.

Results: Thirty-one studies were included in this literature review. Eight studies identified environmental interventions that were effective in managing BPSD. These interventions included: Multisensory Stimulation Environment (MSE), ambient music, minimising acoustics, consistent indoor temperatures, aromatherapy, maximising natural light, increasing the presence of environmental cues and signage, homelike environments and animal assisted therapy. However few studies reported on the impact of environmental enrichment strategies in a subacute inpatient setting. Staff surveys revealed that changes to the ward environment would improve patient’s outcomes and management of BPSD on the ward.

Significance of the findings to allied health:  It is is evident that incorporating environment enrichment strategies to long-term care facilities would benefit the management of BPSD. Allied Health, particularly occupational therapy can play an important role in implementing these strategies. More high quality research is recommended, especially regarding studies measuring the effect on secure, dementia-specific wards and its long-term outcomes.


Bridget Hoole is  Grade 2 Occupational Therapist working in geriatric evaluation and management at the Royal Melbourne Hospital.