|Behavior Analytic Interpretations of Services for Older Adults With Neurocognitive Disorders|
|Sunday, May 26, 2019|
|3:00 PM–4:50 PM |
|Swissôtel, Event Center Second Floor, Vevey 3/4|
|Area: CBM; Domain: Applied Research|
|Chair: Rachel VanPutten (Eastern Michigan University )|
|Discussant: Claudia Drossel (Eastern Michigan University)|
Non-pharmacological interventions, recommended as first-line treatment for various problems associated with cognitive decline in older adults, encompass a broad array of approaches (e.g. music therapy, memory boards, caregiver supported interventions, etc.) with ill-defined mechanisms of change. Interventions are often implemented haphazardly, based upon provider preferences. Behavior analysts, in contrast, deliver services that are conceptually consistent with behavior analytic principles, based upon scientific knowledge. This symposium will describe the rationale and the implementation of non-pharmacological interventions for problems that commonly occur when working with individuals aged 60 and older with neurocognitive disorders and their care partners, and provide behavior-analytic interpretations of their results. The first paper will describe the development of a tool designed to assess training experiences of care partners of older adults. The second paper will present the results of personalized music playlists on indices of happiness, vocalizations, and problem behaviour when compared to a social-visit without music control. The third paper will discuss the value of descriptive functional analyses in understanding behavior within a specialized dementia care unit. The final paper will describe the results of a multicomponent intervention to reduce calling out during mealtimes in a long-term care facility.
|Instruction Level: Basic|
|Keyword(s): neurocognitive disorders, non-pharmacological interventions, older adults, problem behavior|
Elucidating Training Strategies for Care Partners of Family Members With Neurocognitive Disorders: Development of a Novel Assessment Tool
|RACHEL VANPUTTEN (Eastern Michigan University ), Claudia Drossel (Eastern Michigan University), Thomas J. Waltz (Eastern Michigan University)|
Care partners are tasked with the implementation of interventions to ensure the wellbeing and prevent excess disability of their family members with neurocognitive disorders. However, most care partners report that they are ill-prepared, and barriers to implementation are common. Multicomponent interventions are overwhelmingly recommended to remove barriers. Investigation into the various strategies used within multicomponent interventions for care partners suggests that behavioral skills training is most efficacious in decreasing care partner barriers, but it is unclear to what degree and how frequently care partners receive it. The present study describes the development of a tool, based on the Performance Diagnostic Checklist - Human Services (PDC-HS), designed to assess the training experiences of care partners of older adults with neurocognitive disorders. Relevant stakeholders, specifically, care partners of the target population participated in a focus group to provide feedback on the acceptability and feasibility of the tool. Results suggest that while the tool is feasible, further considerations for acceptability are required. Implications of the findings with respect to the dissemination of behavior-analytic principles to care partner training will be discussed.
The Effect of Music on Behavior in Individuals With Dementia
|NICOLE DOMONCHUK (Lambton College), Theresa Stoesser (Bluewater Health), Ashith Dev (St. Clair Catholic District School Board)|
Dementia is a significant global health concern. An estimated 35.6 million people lived with dementia worldwide in 2010, and that number is expected to double every 20 years. Rather than difficulties remembering, thinking, or problem-solving, behavioural problems associated with dementia such as agitation, wandering and aggression are the main reason for institutionalization. Non-pharmacological interventions are mandated as first-line interventions to prevent or manage the behavioural symptoms of dementia. Music-based interventions are one approach that has recently gained popularity. The purpose of this study was to identify whether personalized music playlists had any observable effect on participant indices of happiness, vocalizations, and problem behaviour when compared to a social-visit without music control. Four caregiver/participant dyads participated. Results suggest that the impact of music was not uniform across participants. Regardless of objective behaviour change observed, all caregivers reported high satisfaction with the study. Implications of these results within a behavior analytic framework will be discussed.
|Lessons Learned as BCBA's New to Gerontology|
|JENNIFER LYNNE BRUZEK (Jacksonville State University), Claudia Drossel (Eastern Michigan University), Sara Posey Gaines (Behavioral Innovations, Texas), Makenzie Williams Bayles (Jacksonville State University)|
|Abstract: It is estimated that 5.7 million Americans are living with Alzheimer’s dementia in 2018. The prevalence of neurocognitive disorders and associated problem behavior coupled with the shortage of behavior analysts working with this population suggest a need for further investigation. The purpose of our study was to identify the environmental events that evoke and follow behavior in a specialized dementia care unit. We observed nine participants diagnosed with dementia in their natural environment to identify correlations between antecedent events (e.g., no attention), target behaviors (e.g., non-contextual speech), and consequences (e.g., delivery of attention). Comparisons of response-independent and conditional probabilities showed mostly negative contingency values, suggesting that attention and materials were more likely to occur non-contingently. The rationales and the implications of our findings will be discussed with respect to the idiosyncratic characteristics of this population. Our results suggest descriptive analyses provide a valuable tool for understanding general behavior patterns of these individuals and their care partners.|
|An Evaluation of a Multicomponent Intervention for Reducing Repetitive Requests in Applied Dementia Care|
|NICK FELTZ (The Royal Ottawa Mental Health Centre)|
|Abstract: The representation of aging adults both in behaviour analytic research and clinical practice has long been recognized as deficient (Burgio & Burgio, 1986). Prevailing limitations noted in existing literature include the absence of follow-up data demonstrating the longevity of behaviour analytic interventions, and a lack of social validity data precluding evaluations on the acceptability of interventions by service recipients and caregivers. The current study aims to address the existing limitations while evaluating a caregiver implemented multicomponent intervention designed to reduce repetitive requests exhibited during mealtime routines by an 87-year-old woman diagnosed with dementia. A multiple baseline design was used to evaluate the efficacy of the intervention across mealtime routines in the dining room of the participant’s current a long-term care home. In addition to behavioural data, treatment integrity and social validity scores were also collected for evaluation. The results of the behavioural data conclude a reduction of repetitive requests below 50% of baseline occurrences across mealtime routines following the implementation of the multicomponent intervention. Moreover, the data demonstrates a noteworthy correlation between 100% treatment integrity scores and reductions to 0 occurrences of repetitive requests during mealtime routines. Additionally, social validity scores concluded positive responses from caregivers who mediated the intervention. The current evaluation provides further evidence consistent with existing empirical research demonstrating efficacious applications of behavioural interventions within dementia care settings.|