Many patients with Alzheimer's disease (AD) demonstrate disruptive behaviors that are distressing to themselves and to their caregivers. This article will examine how to use a behavioral approach to help manage such behaviors. The approach is based on four steps involving the clinician and the caregiver:
• Analysis of the behavior
• Identification of behavioral strategies
• Choice and implementation of a behavioral intervention
• Evaluation followed by modification of the plan as required.
A synopsis of available behavioral strategies are included here to help the clinician discuss alternatives with caregivers.
References
1.
American Association for Geriatric Psychiatry, Behavioral Disorders in Dementia Curriculum Planning Committee : Behavioral disorders in dementia: Agitation, aggression, and psychosis—What the clinician needs to know. Bethesda: American Association for Geriatric Psychiatry, 1998.
2.
Beck CK , Shue VM: Interventions for treating disruptive behavior in demented elderly people. Nursing Clinics of North America. 1994; 29(1): 143-155.
3.
Pfeiffer E : Issues in Alzheimer's disease: Managing disruptive behaviors. Tampa: Suncoast Gerontology Center, 1993.
4.
Zarit SH , Zarit JM: Mental disorders in older adults: Fundamentals of assessment and treatment. New York: Guilford Press, 1998.
5.
Teri L , Logsdon R, McCurry S: Managing agitation in Alzheimer's disease: A training program in behavior management techniques. Seattle: University of Washington School of Medicine, Department of Psychiatry & Behavioral Science, 1994.
6.
Cohen-Mansfield J , Bellig N: Agitated behaviors in the elderly: A conceptual review. Journal of the American Geriatric Society. 1986; 34: 711-721.
7.
Cohn MD , Smyer MA, Horgas AL: The A-B-Cs of behavior change: Skills for working with behavior problems in nursing homes. State College, PA: Venture, 1994.
8.
Landreville P , Bordes M, Dicaire L, Verreault R: Behavioral approaches for reducing agitation in residents of long-term-care facilities: Critical review and suggestions for future research. International Psychogeriatrics. 1998; 10(4): 397-419.
9.
Beck CK : Psychosocial and behavioral interventions for Alzheimer's disease patients and their families. The American Journal of Geriatric Psychiatry. 1998; 6(2): S41-S48.
10.
Johnston L , Gueldner SH: Using mnemonics to boost memory in the elderly. Journal of Gerontological Nursing. 1989; 15(8): 22-26.
11.
Ripich DN , Wykle M, Niles S: Alzheimer's disease caregivers: The FOCUSED program. Geriatric Nursing. 1995; 16(1): 15-19.