9 MARCH 2025ELDERCARE REVIEWbehavioral and psychological symptoms of dementia (BPSD) and chronic pain in older adults, it also reveals a concerning trend. Medications such as gabapentin, trazodone, and valproic acid are being increasingly used for similar purposes, often off-label.One review of the study states, "This raises an important issue, one of a recurring pattern of off-label psychotropic substitutions to treat conditions such as behavioral and psychological symptoms of dementia (BPSD) and chronic pain in older adults. It also highlights how well-intentioned deprescribing efforts may result in the unintended consequence of increasing use of medications with similar harms and questionable benefits."These findings call for reflection. Are we tracking not only reductions in certain medications but also the substances replacing them? Are we staying true to the commitment to holistic, well-being-focused options?The answer may lie in a growing trend toward non-pharmacological, wellness-based approaches. These approaches, often spearheaded by life enrichment and holistic dementia care professionals, prioritize health, engagement, and quality of life over medication. Today, life enrichment and holistically oriented professionals are as vital in preventing and managing BPSDs as clinical providers were in the past.Life enrichment professionals go beyond traditional caregiving, crafting experiences tailored to each individual's history, preferences, and abilities. By addressing unmet needs that manifest as behavioral expressions such as frustration, boredom, or loneliness, they foster emotional well-being and a sense of purpose.Integrating these strategies into care plans can dramatically reduce reliance on psychotropic medications. This shift not only improves residents' quality of life but also reaffirms the profession's commitment to a well-being-focused care model that honors the dignity and humanity of individuals living with dementia.Moving forward, senior living communities must recognize the transformative potential of life enrichment and dementia care professionals. Their work is far more than a full calendar of activities--it is an essential part of addressing BPSDs and enhancing overall quality of life. True progress requires consistent collaboration between life enrichment professionals and clinical teams, focusing on resident-driven care outside of routine meetings.Finally, equipping these professionals with the resources, training, and tools necessary to create meaningful, data-driven wellness plans is crucial. By supporting their efforts, we can move closer to the ultimate goal: reducing reliance on side-effect-heavy psychotropics and achieving truly holistic, person-centered care.
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