This Symposium at the ABA International Annual Conference Phoenix, AZ illustrates 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..."
In 1900, the average American lifespan was was about 47 years old; today, 50% of those who reach the age of 55 can be predicted to live into their 80's. While recognition that we are living longer has encouraged lifestyle changes to maintain health and activity longer, there are many issues left to be studied, since there remain age-related changes in quality of life, increasing risk of health problems and age-related dementias or Alzheimer's Disease. Some research suggesting that by the age of 85, over half of the aging population will have some measurable cognitive impairment.
A simple google search under "silver tsunami" or "aging tsunami" will show that the aging baby boom wave is a matter of pressing concern to policymakers, gerontologists, and human and medical delivery services.
The Growing Older Population
The United States is experiencing a longevity revolution and as the baby boomers approach retirement age, they are touching off an age wave that will double the number of Americans over age 65 to more than 70 million. Individual life expectancy is also increasing and the older population is growing much more rapidly than the entire population of the United States. The prevalence of chronic disease within our senior population has already resulted in increased national health care spending, high rates of disability, and much human suffering. The problem, then, only stands to become exponentially worse as our elderly population grows.
The Silver Book®
The Alliance for Aging Research
YouTube: Research on Aging: Quality of Life and Aging
Theodore Ganiats, MD: 6/12/2008 55 minutes
UCTV. Topic is defining "quality of life" and impact on mortality
http://www.youtube.com/watch?v=QFpfb8KcD-8
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#197 Symposium
5/24/2009
10:30 a.m. - 11:50 a.m.
North 132 BC
DEV/Applied Behavior Analysis
Preparing for the Aging Tsunami: Behavior Analysis of Problems in Late Life
Chair: Christina G. Garrison-Diehn (University of Nevada, Reno)
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.
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.
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.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.-----------------
Related presentations:
#30 Paper Session, 5/23/2009, 1:00 p.m. - 2:20 p.m., North 132 BC
DEV
Behavior Analysis of Aging and Health Issues
Chair: Celia Wolk Gershenson (University of Minnesota)
#58 Symposium, 5/23/2009, 2:30 p.m. - 3:50 p.m., North 128
DDA/DEV; Applied Behavior Analysis
Advancements in Preference and Choice Research across Multiple Applied Contexts
Chair: Richard G. Smith (University of North Texas)
- Preference Assessments for Older Adults with Dementia: Stability of Preferences Identified by Multiple Stimulus Assessments. PAIGE BROOKLEY RAETZ (Western Michigan University), Linda A. LeBlanc (Western Michigan University), Jonathan C. Baker (Western Michigan University), Laura C Hilton (Western Michigan University)
EAB; Experimental Analysis
SQAB Tutorial: Cognitive Aging: A Behavior Theoretic Approach
Chair: Celia Wolk Gershenson (University of Minnesota)
JOEL MYERSON (Washington University)
#96 International Poster Session, 5/23/2009, 6:00 p.m. - 7:30 p.m., North Hall A
CBM
55. What’s in a Name?: Modified Spaced-Retrieval Training for Improving Recognition of Family Caregivers in Persons with Alzheimer’s Disease. (DEV; Applied Behavior Analysis) MERRY SYLVESTER (University of Nevada, Reno), Jane E. Fisher (University of Nevada, Reno)
#98 International Poster Session, 5/23/2009, 6:00 p.m. - 7:30 p.m., North Hall A
DEV
62. Evaluation of Preference Formats and Types of Activities Offered in Nursing Homes with Older Adults with Alzheimer’s Disease. (Applied Behavior Analysis) AMANDA LEONE RYAN (Southern Illinois University), Maranda Trahan (Southern Illinois University Carbondale), Levon Johnson Jr. (Southern Illinois University), Kari A Porter (Southern Illinois University), Paula K. Davis (Southern Illinois University)
#362 Symposium, 5/25/2009, 9:00 a.m. - 10:20 a.m., North 132 BC
DEV/DDA; Applied Behavior Analysis
Effects of Various Procedures on Engagement in Activities and Escaped Maintained Behaviors in Older Adults
Chair: Diana J. Walker (The Chicago School of Professional Psychology)
Discussant: John P. Smagner (University of Chicago)
#437 Symposium, 5/25/2009, 1:30 p.m. - 2:50 p.m., North 132 BC
DEV/CBM; Service Delivery
Application of Behavior Analysis to Improve Quality of Life for Individuals with Dementia
Chair: Clair Rummel (University of Nevada, Reno)
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Some references and for further reading,
Behavioral Gerontology Special Interest Group ABA International
Aging Gracefully
Margaret Vaughan with Ken Stephens
Cambridge Center for Behavioral Studies
Behavioral Gerontology (powerpoint)
Linda LeBlanc and Allison Jay
The Silver Book®
The Alliance for Aging Research
National Institute on Aging
U.S. National Institutes of Health
AgingStats.gov
Reports and Statistics, including,
Older Americans 2008: Key Indicators of Well-Being
Dialectical Behavior Therapy
National Registry of Evidence-based Programs and Practices (NREPP),
Substance Abuse and Mental Health Services Administration (SAMHSA)
Dwyer-Moore, K.J., & Dixon, M.R. (2007). Functional analysis and treatment of problem behavior of elderly adults in long-term care. Journal of Applied Behavior Analysis, 40(4), 679-683.
doi: 10.1901/jaba.2007.679-683.
Buchanan, J., Husfeldt, J., Berg, T., & Houlihan, D. (2008). Publication trends in behavioral gerontology in the past 25 years: are the elderly still an understudied population in behavioral research?. Behavioral Interventions, 23(1), 55-74.
doi: 10.1002/bin.254
Burgio, L.D., & Burgio, K.L. (1986). Behavioral gerontology: application of behavioral methods to the problems of older adults. Journal of Applied Behavior Analysis, 19(4), 321-328.
doi: 10.1901/jaba.1986.19-321.
Engelmann, K.K., Matthews, R.M., & Altus, D. E. ( 2002). Restoring dressing independence in persons with Alzheimer's disease: A pilot study. American Journal of Alzheimer's Disease and Other Dementias®, 17(1), 37-43.
DOI: 10.1177/153331750201700102
Gallagher, S.M., & Keenan, M. (2000). Independent use of activity materials by the elderly in a residential setting. Journal of Applied Behavior Analysis, 33(3), 325-328.
doi: 10.1901/jaba.2000.33-325.
Bourgeois, M.S. (1990). Enhancing conversation skills in patients with Alzheimer's disease using a prosthetic memory aid. Journal of Applied Behavior Analysis, 23(1), 29-42.
doi: 10.1901/jaba.1990.23-29.
Publications for Professor Mark Mathews
(lengthy reference list of behavioral research in gerontology)
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3 days and counting...
DISCLAIMER: Personal opinion and blog, not an official outlet intended to represent ABA-International® or other official entity or organization.
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