|A Behavioral Prescription for Middle-Aged and Older Adults: Eat Better, Sleep Better, and Get Active
|Sunday, May 30, 2010
|9:00 AM–10:20 AM
|Travis A/B (Grand Hyatt)
|Area: DEV/CBM; Domain: Applied Behavior Analysis
|Chair: Leilani Feliciano (University of Colorado at Colorado Springs)
|Abstract: Chronic illnesses and sleep disturbances are common in both community and long-term care populations. These medical problems are multifaceted and typically necessitate a bio-psycho-social and behavioral approach for adequate management. This symposium addresses two of the most commonly occurring medical disorders in middle-aged and older adults: type II diabetes and sleep disorders. Adherence with diet, exercise, and other medical recommendations is a challenge for community dwelling adults with type Ii diabetes and can be exarcerbated in adults who live in long-term care settings. Presenters will discuss and present data from several studies using behavioral approaches to tackling common challenges involved in managing diabetes including: increasing healthy food choices to maintain adequate nutrition in community dwelling and nursing home populations and increasing exercise and access to reinforcing activities in low income adults with comorbid depression and diabetes. Finally, sleep diaries and polysomnographic studies are the most common methods of assessing sleep disturbance, but neither approach is appropriate for use with nursing home residents experiencing dementia. Presenters will discuss a novel approach to assessing sleep disturbances in older adults with dementia living in long-term care settings. The implications of these findings and potential for environmental and behavioral solutions will be discussed.
|Using Preference Assessments in a Tailored Behavioral Intervention to Manage Nutrition in Adults With Diabetes
|SARAH ANDERSON (University of Colorado at Colorado Springs), Allison A. Jay (University of Colorado at Colorado Springs), Mary E Steers (University of Colorado at Colorado Springs), Kaitlyn Marie Eller (University of Colorado at Colorado Springs), Leilani Feliciano (University of Colorado at Colorado Springs)
|Abstract: Type II diabetes is one of the most common chronic diseases in the U.S. affecting 1/10 adults, and thus represents an important target for intervention. Nonadherence with diet and medical recommendations remains a challenge for many adults despite demonstrating sufficient knowledge of treatment procedures. The high prevalence of diabetes and associated medical complications in adults suggests simple education and diet recommendations are not enough. Low income community dwelling individuals need easy to manage, tailored interventions (TI) that consider the unique environmental stimuli relevant for their diet and health behaviors. Preference assessments (PA) may have utility in identifying healthy food options that appeal to the individual and can be used with a tailored behavioral intervention. Studies have shown that PA, when used with TI, have been effective in establishing and reinforcing healthy eating behaviors across several different populations including children with autism, adults with developmental disabilities, and in typically developing children with food refusal. However, the PA strategy has not been applied to managing nutrition in adults with diabetes. This study investigates whether the use of PA for heatlhy food choices as part of TI results in better diabetes-related outcomes in seven low income, middle-aged adults with type II diabetes.
|An Evaluation of Healthy Food Choices in Nursing Home Dwelling Older Adults With Diabetes
|JONATHAN C. BAKER (Southern Illinois University), Mark R. Dixon (Southern Illinois University), Stephanie Hood (Southern Illinois University)
|Abstract: Diabetes has been shown to increase the risk of nursing home placement in older adults (Andel, Hyer, & Slack, 2007). Once in the nursing home, diabetes increases the risk of infection-related hypoglycemia (IRH; Arionzon, Fidelman, Berner, & Adunsky, 2007) as well as decreases the survival rate for older adults diagnosed with dementia (Mitchell et al., 2004). The present investigation evaluated food choices of nursing dwelling older adults during buffet style meals. Following baseline, an intervention was developed to promote healthy choices at mealtime. Implications for the sustainability and social validity of such interventions will be discussed.
|The Impact of Behavioral Activation Therapy on Adults With Depression and Diabetes
|ALLISON A. JAY (University of Colorado at Colorado Springs), Mary E Steers (University of Colorado at Colorado Springs), Sarah Anderson (University of Colorado at Colorado Springs), Leilani Feliciano (University of Colorado at Colorado Springs)
|Abstract: Type II diabetes is one of the most common chronic diseases among older adults in the United States. Research suggests that the occurrence of depression is significantly higher in individuals with diabetes compared to the general population. The onset of depressive symptoms may make diabetes self-care activities more challenging, and may influence one’s compliance with medication regimens, exercise routines, nutrition plans, and glucose monitoring tasks. Research literature suggests that depression management interventions can produce better diabetes related outcomes, increase individual life-expectancy, and improve quality of life. Behavioral Activation is an empirically supported treatment that focuses on identifying escape and avoidance contingencies that maintain current depressive behavior, and uses functional interventions to engage the client in meaningful activities that increase their contact with positive reinforcement. Behavioral Activation involves focusing on the relationship between behavioral contingencies and mood. An overview of the BA model will be presented, as well as specific applications to working with clients with diabetes. Data on mood and diabetes-related outcomes (e.g., blood glucose level, behavior change) will be presented for five individuals with diabetes and depression who completed the intervention.
|How Does Anybody Sleep Around Here? Sleep Disturbance in Dementia Care Units
|R. MARK MATHEWS (University of Sydney), Chin Moi Chow (University of Sydney), Jacky Ho (University of Sydney)
|Abstract: Sleep disturbances in older people are common and multifaceted. Sleep diaries and polysomnographic studies are the most common methods of assessing sleep disturbance, but neither approach is appropriate for use with nursing home residents experiencing dementia. A wrist actigraph is a small watch-like device that records movement and provides objective data by interpreting presence of movement as time awake and absence of movement as sleep. Actigraphy data were collected with residents of six Australian dementia-care units. Results suggest that most residents were frequently woken during the night (some experienced over 200 sleep disturbances per night), some had difficulty falling asleep (sleep latency averaging over 90 minutes for some residents), and many had difficulty staying asleep (sleep efficiency for some residents was under 40%). Implications of these findings and potential for environmental and behavioral solutions will be discussed.