Integrated behavioral health increases service utilization and treatment success, particularly with high-risk populations. This study assessed medical personnel's attitudes and perceptions of behavioral health clinicians (BHCs) in primary care using a brief self-report measure. A 6-item survey was given to medical providers (n = 45) from a health care system that includes integrated behavioral health services. Survey items assessed providers' attitudes and perceptions about BHCs. Attitudes about behavioral health were largely favorable. For all items, 73.3% to 100% of participants endorsed strongly agree or agree. Chi-square analyses revealed that those who interacted more frequently with BHCs were more comfortable discussing behavioral health issues with their patients, χ²(6, n = 45) = 13.43, p < .05, and that physicians believe that BHCs help patients effectively address their behavioral health problems, χ²(2, n = 45) = 6.36, p < .05. Age, gender, and health center in which the providers worked were not significantly related to any survey items. Medical providers surveyed believe that BHCs are valuable members of integrated health care, improving their abilities to provide care and to address their patients' physical and behavioral health problems. Although these preliminary results are promising, the setting surveyed has well-integrated behavioral health care services and thus might not be representative of other settings without such integration. Future studies should address medical providers' opinions of BHCs in a variety of settings with larger samples.
As cognitive impairment progresses, individuals with dementia gradually decline in activity engagement due to difficulties initiating leisure activities independently and effectively communicating their preferences. Low activity engagement has negative implications for mood and quality of life. To address this difficulty, preference assessments (PA) can be effectively used to determine the likes and dislikes of individuals with dementia. The present study assessed the utility of PA and the stability of preferences over time (i.e., 1 and 6 months after initial assessment) in a sample of older adults with dementia (M age ϭ 82.25 years, SD ϭ 6.52 years). Results supported the use of PA as an assessment procedure to assess preferences for items or leisure activities in adults with moderate to severe dementia. The majority of participants exhibited stable patterns of preference over 1 to 6 months with correlation coefficients exceeding r s ϭ .50, suggesting that preferences may remain stable for some individuals with dementia. Research and clinical implications of the use of PA in this population are discussed.
Dementia care residents frequently experience difficulty locating their bedrooms, which creates challenges for both residents and staff. Previous research suggests that hanging items outside individual bedrooms can help facilitate room finding. This project involved a multiphase study designed to systematically investigate whether recognition and personal relevance of showcased items facilitates better room finding. Participants (n = 6) included older adults (Mage = 89.67, SD = 3.20) with moderate to severe cognitive impairment living in dementia care communities; data collection was terminated before evaluation of the intervention was possible with 1 participant due to adverse health events. Accuracy of room selection was measured through direct observation in a baseline condition (i.e., empty shadow box), then participants were randomly assigned to either personalized (i.e., well-recognized pictures, names, and items) or landmark (i.e., distinctive but not self-referent items) experimental conditions. Nonconcurrent multiple baseline across participants single-subject research methodology was used to empirically evaluate the intervention. Significant improvements in room finding were observed for 50% of participants across experimental conditions. The results suggest that distinctive landmark properties of shadow boxes are critical in improving room finding and that landmarks alone (without personal identifiers) are sufficient for some people. Anecdotal evidence suggests that personalization of boxes is preferred by families and staff and is more congruent with person-centered care.
Individuals with dementia have difficulty distinguishing their personal items and spaces from others, which creates problems in long-term care (LTC). Prosthetic memory aids may help facilitate recognition. This study assessed which self-referent stimuli were best recognized by individuals with dementia. LTC residents with dementia ( n = 27) were shown arrays of three stimuli and asked to select the picture/name that featured them. Stimulus arrays included photographs from young adulthood, middle adulthood, current age, and their printed name. Most participants (95%) completed the assessment and recognized at least one stimulus type above chance levels. Participants recognized printed names most accurately ( M = 89%). Current photographs were recognized least ( M = 64%). Printed names and early adulthood photographs facilitate self-recognition in individuals with dementia.
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