Outline:

I.          What is dementia?

a.         Not a disease but a constellation of symptoms

b.         Many conditions can cause symptoms

i.          Potentially treatable conditions – B12, NPH, hypothyroidism, etc.

ii.          Irreversible conditions – Alzheimer’s, VaD, FTD, Lewy body, etc

c.         Diagnosis of exclusion

II.         Impact

a.         Person with Dementia

i.          Depression and neuropsychiatric symptoms are associated with poor quality of life.

b.         Family Caregivers

i.          Behavioral problems are a strong predictor of caregiver burden.

ii.          High association between challenging behaviors and nursing home placement.

c.         Professional Caregivers

i.          Agitated behaviors are associated with staff burnout and stress.

ii.          Disruptive behaviors are significantly correlated with higher burden.

III.        Behavioral and Psychological Symptoms of Dementia (BPSD)

a.         Behavior is communication and has meaning

b.         Common behavioral triggers

i.          Pain

ii.          Caregiver interaction

iii.         Environment

iv.        Stress, frustration

v.         Medication interaction

c.         Antipsychotics a last resort

i.          Smoke detector analogy

IV.        Identifying Behavioral Triggers using A-B-C Model

a.         Applying ABA behavioral interventions to BPSD.

i.          Put the behavior in context.

ii.          If you understand “why” a behavior occurs you can plan an intervention to manage the behavior.

iii.         Identify the trigger to resolve the behavior

b.         A-B-C Model – Focus on the factors that impact behavior

i.          Antecedents – Behaviors – Consequences

ii.          Shift focus from the “B” to the “A.”

iii.         Observe, Analyze, Intervention

V.         Review

Kathryn Pears is a dementia expert with over 30 years personal and professional experience.  Ms. Pears is principal of Dementia Care Strategies and provides training and consulting services to a range of aging and disability service providers. Ms. Pears specializes in the non-pharmacologic management of the challenging behaviors that occur with dementia. Prior to forming Dementia Care Strategies, she was with the Alzheimer's Association, Maine Chapter for 15 years. Kathryn also co-chairs the National Task Group on Intellectual Disabilities and Dementia Practices training and curriculum workgroup that developed a national model curriculum on dementia-capable care of adults with intellectual/developmental disabilities and dementia. As co-lead trainer for the model curriculum, she travels the country conducting multi-day workshops on behalf of the NTG. She is also a consultant in non-pharmacologic interventions for behavioral symptoms of dementia and clinic coordinator for the American Academy of Developmental Medicine and Dentistry's (AADMD) Project ECHO® ID and Dementia telehealth project and Trinitas Regional Medical Center in New Jersey's GWEP ECHO® telehealth project.

Disclosure: Kathryn Pears, MPPM has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.