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| Preparing for the Aging Tsunami: Behavior Analysis of Problems in Late Life |
| Sunday, May 24, 2009 |
| 10:30 AM–11:50 AM |
| North 132 BC |
| Area: DEV; Domain: Applied Behavior Analysis |
| Chair: Christina G. Garrison-Diehn (University of Nevada, Reno) |
| Abstract: Advances in medical technology coupled with the aging of the baby-boomer generation will produce the largest population of older adults society has seen, with projections of 80 to 90 million Americans over the age of 65 by 2050. The behavior analytic community would be wise to increase attention toward issues of late-life in preparation for this “aging tsunami.” This symposium focuses on behavior analytic approaches to problems in late life. The papers describe a variety of strategies for promoting behavioral health of older adults including: promoting choice to reduce depression in nursing home residents; an analysis of the effects of gambling on activity level and well-being of nursing home residents; evaluation of the adaptation of a skills training protocol to remove barriers to effective caregiving in high risk families; and an individualized intervention to promote behavioral health strategies in older persons with diabetes. The goal of this symposium is to illustrate the variety of areas behavioral analytic strategies are relevant for promoting behavioral health in late life. |
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| Promoting choice: A new treatment for depression in nursing home residents |
| CLAIR RUMMEL (University of Nevada, Reno), Jane E. Fisher (University of Nevada, Reno) |
| Abstract: Estimates of the likelihood that an older person will spend time in a nursing home during their lifetime are 30% for men and 50% for women. A significant challenge in the care of elderly persons within nursing homes is the high prevalence rate of psychological problems, especially depression. The central goal of this study was to evaluate a brief new treatment for depression in nursing home residents based on the following two components: 1) behavioral activation in which individualized schedules of preferred activities were created and implemented, 2) integration of opportunities for residents to make choices about how they allocate their time. A multiple baseline across participants design was used to evaluate the effects of the intervention on the activity level and mood of three nursing home residents. Outcome measures included direct observation of activity participation, participants’ self report of mood and depressive symptoms, and medication changes. Results indicated an increase in observed activity participation and positive affect across all three participants. Two participants experienced a decrease in depressive symptoms. Results of this study indicate that increasing access to preferred activities through the use of idiographic activity schedules and increased opportunities for choice is both beneficial for residents and practical. |
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| Gambling in the Elderly: Risk or Benefit |
| Mark R. Dixon (Southern Illinois University), JESSICA L. FOUCH (Western Michigan University) |
| Abstract: Over the past 10 years or so increasing reports have been
emerging in the popular press that gambling may in fact have positive side-effects for the elderly. It has been documented that the elderly who gamble have larger social networks and have later onset of degenerative diseases than those whom do not gamble. Regardless of positive side-effects, gambling can become problematic for anyone, including the elderly and lead to great financial and psychological loss. This presentation will examine the utility of allowing individuals living in long-term care facilities for the elderly to have the opportunity to gamble on a regular basis. A computerized slot machine as well as table games were introduced into the residence and subsequent resident activity and psychological factors were assessed. It appears that when monitored for overuse / abuse, the introduction of gambling related activities in nursing homes may have positive impact for many residents. |
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| Removing family barriers to implementing behavioral care plans |
| CLAUDIA DROSSEL (University of Nevada, Reno), Jane E. Fisher (University of Nevada, Reno) |
| Abstract: When training family members to implement behavioral plans, barriers to adherence are ubiquitous. In our work with family members of elderly individuals with dementia, we anecdotally observed that the failure to implement recommended behavioral strategies correlated with caregivers’ avoidant behavior patterns (e.g., wishful thinking) and depressed behavior (e.g., reported loss of hope). We hypothesized that low interpersonal effectiveness, marked by deficient coping and self-care skills, might pose a barrier to effective care-giving and implemented an eight-week Dialectical Behavior Therapy (DBT) skills training protocol, modified to promote strategies for effective communication with persons with dementia. DBT skills training establishes the repertoires necessary for managing severe psychological distress. In a pretest-posttest design and without experimental control, the effects of DBT skills training on self-reported depressed behavior, avoidant coping, burnout, self-care, and caregiver burden were assessed to explore the development of an intervention that may increase adherence. Data from a convenience sample of 20 caregivers, some of whom were elder protective services cases, suggest that such skills training could present a time-efficient and practical intervention to break down barriers to active participation in treatment planning and implementation. |
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| Using Behavior Analysis to extend current models of diabetes management in older adults |
| LEILANI FELICIANO (University of Colorado, Colorado Springs), Mary E Steers (University of Colorado at Colorado Springs), Allison A. Jay (University of Colorado at Colorado Springs), Sarah Anderson (University of Colorado, Colorado Springs) |
| Abstract: Chronic diseases are common amongst older adults and the prevalence increases with age. Type II diabetes is one of the most common chronic diseases in the U.S. affecting 1/5 elders, and thus represents an important target for intervention. Nonadherence with medical recommendations is a concern for all medical patients including older adults. Even with serious chronic conditions such as diabetes few elders fully adhere to treatment regimens, despite demonstrating sufficient knowledge of treatment procedures. The high prevalence of diabetes and associated medical complications in elders suggests simple education and diet recommendations may not be enough. Prior research has indicated that psychosocial interventions can improve the psychological and physical well being of patients with chronic medical conditions. However, adequate diabetes management requires a high degree of individual self-management strategies. Community dwelling elders need easy to manage, individually tailored interventions that consider the unique environmental factors relevant for their diet and health behaviors. Thus, an individualized home-based consultation approach (IHBC) may prove useful for community dwelling elders with type II diabetes. This study investigates whether participation in IHBC results in better diabetes related outcomes than a health education group alone in low income older adults with type II diabetes. |
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