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| Application of Behavior Analysis to Improve Quality of Life
for Individuals with Dementia |
| Monday, May 25, 2009 |
| 1:30 PM–2:50 PM |
| North 132 BC |
| Area: DEV/CBM; Domain: Service Delivery |
| Chair: Clair Rummel (University of Nevada, Reno) |
| Abstract: Current estimates show that 3.4 million adults, approximately one in seven adults over the age of 71, have some form of dementia (National Institute on Aging, 2007). As demographics shift over the next decade the growing need for restraint-free interventions to improve quality of life for both the individual with dementia and the caregiver will intensify. Individuals with dementia experience a progressive loss of ability to communicate, carry out tasks of daily living and maintain relationships. The presentations will outline behavioral interventions that decrease losses associated with dementia, including interventions to increase verbal repertoires using an idiographic approach to communication training; facilitate item recall through the use of tacts, echoics and intraverbals; and use self-referent stimuli to increase wayfinding ability in individuals with dementia. The growing needs of individuals with both Down syndrome and dementia of the Alzheimer's Type will be addressed
in a new conceptualization of the effects of function-based interventions designed to reduce agitation in this population. |
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| Facilitating Conversation in Alzheimer’s Disease: An Idiographic Approach to Communication Training for Family Caregivers |
| RUTH GENTRY (University of Nevada, Reno), Jane E. Fisher (University of Nevada, Reno) |
| Abstract: The loss of verbal repertoires is an inevitable consequence of Alzheimer’s disease (AD). Communication difficulties are among the most stressful problems family caregivers report. This study employed a multiple baseline across caregiver/care-recipient dyads to evaluate the effects of an individualized approach to caregiver communication training. Four family caregivers were taught to modify specific verbal behaviors to create a non-punitive, supportive communicative environment for their family member with dementia. Coding of audio recordings of dyad conversations in the natural environment indicated that caregivers’ verbal behaviors significantly impacted the fluency and coherence of the speech of AD participants. Fewer communication problems occurred within dyads following caregiver training. Results indicate that individualized caregiver communication skills training can create environments that facilitate rather than punish the conversational speech of persons with AD, thereby promoting the preservation of verbal repertoires in persons with AD and meaningful relationships between persons with AD and their families. |
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| Using Tacts, Echoics, and Intraverbals to Facilitate Item Recall in Persons with Dementia |
| Mark R. Dixon (Southern Illinois University), Katie A Sadowski (SIU-Carbondale), LAURA BARNES (Southern Illinois University) |
| Abstract: Skinner’s 1957 analysis of Verbal Behavior has demonstrated a fair amount of utility to teach language to children with autism and other various disorders. However, the learning of language can be forgotten, as is the case for many elderly suffering from dementia or other degenerative diseases. It appears possible that Skinner’s operants may facilitate not only acquisition of language but also the ability to recall items or objects that may have appeared to be “forgotten”. The present study examined the utility of having a series of adults in long term care emit either tacts, echoics, or intraverbals upon presentation of various visual stimuli. Compared to a no-verbal response condition, it appears that the incorporation of Skinner’s verbal operants can in fact improve recall for this population. Implications for the re-training of lost language are presented. |
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| Wayfinding in Nursing Home Residents with Dementia |
| ALLISON A. JAY (University of Colorado at Colorado Springs), Leilani Feliciano (University of Colorado, Colorado Springs), Sarah Anderson (University of Colorado, Colorado Springs), Linda A. LeBlanc (Auburn University) |
| Abstract: There is a growing population of older adults with dementia that are residing in long term care settings. These individuals commonly experience difficulty locating their bedroom as a result of limited learning histories and ineffective discriminative stimuli to help distinguish individual bedrooms. Ineffective wayfinding abilities may expose elders to safety hazards and may create problems for other residents and staff. Study 1 investigated the ability of four elders with severe dementia to recognize various self-referent stimuli (i.e., young adulthood photograph, middle adulthood photograph, current photograph, and printed name). Residents that were able to meaningfully recognize at least one type of stimulus then participated in an intervention in which the various stimuli (i.e., best recognized stimulus, poorest recognized stimulus, no stimulus) were posted outside their bedroom doorway during assessment probes and room finding abilities were measured using direct observation techniques. Data are presented as accuracy and latency to room finding. Subsequent studies (Study 2 and 3) improve upon the first study by investigating the effects of various stimulus presentations (i.e., memory box vs. bulletin board), and the effects of discrimination training on wayfinding abilities. Results from Study 2 and 3 on resident room finding will be discussed. |
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| Behavioral Interventions to Reduce Agitation in Individuals with Downs syndrome and Dementia |
| MARY E STEERS (University of Colorado at Colorado Springs), Leilani Feliciano (University of Colorado, Colorado Springs) |
| Abstract: Individuals with developmental disabilities have a longer life expectancy than ever before. Yet, adults with Down’s syndrome (DS) are at an increased risk of developing dementia of the Alzheimer’s type (DAT), with prevalence rates of ranging from 50-75% by age 65 (Torr & Davis, 2007). Individuals with DAT often exhibit agitation (i.e., physical and/or verbal aggression), which negatively affects quality of life (QoL) and increases caregiver burden. Previously, physical or chemical restraints have been used to manage agitation (Cohen-Mansfield, Libin, & Marx, 2007) but the negative consequences associated with these strategies mandates the use of alternative interventions. Behavioral interventions to reduce agitation in individuals with DS and in individuals with DAT are often effective, but few studies investigated interventions in individuals with both DS and DAT. It is crucial to initiate empirically-derived, behaviorally-based approaches to manage behavior problems in this population. We present a conceptualization of the effects of function-based interventions designed to reduce agitation in individuals with DS and DAT. This project seeks to use functional assessment and resulting function-based interventions to effectively manage agitation with the goal of decreasing perceived caregiver burden and stress and increasing QoL for both the caregiver and the individual with DS and DAT. |
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