Behavioral problems and psychological symptoms of dementia (BPSD) are commonly encountered in nursing homes. The literature shows that nonpharmacological methods of controlling undesirable behaviors in patients with dementia include staff education, activity interventions, and sensory stimulation. When these interventions fail, pharmacological therapy may include antipsychotics, cholinesterase inhibitors, and anticonvulsants, which are prescribed for BPSD management off-label. In this article, the author outlines the best evidence-based practice interventions, based on her literature review, for reducing problematic BPSD in the nursing home population. Although the literature supports nonpharmacological treatment as first-line therapy in these patients, there have been no large, high-quality studies conducted to identify which interventions work best in long-term care settings, indicating that this is an area where future research is needed. Additionally, due to the absence of medications approved for BPSD by the US Food and Drug Administration, pharmacovigliance is vital when prescribing available medications in this vulnerable patient population.