Educational interventions about depression should be specifically geared to meet the needs of paraprofessional caregivers who provide the majority of care to LTC residents, yet possess less knowledge about depression and its treatments.
SUMMARYContext Despite a growing literature on effective interventions for Alzheimer's disease (AD) and agitation, the management of these conditions in long term care (LTC) often is inadequate. The goals of the present study were: (a) to evaluate existing beliefs about evidence based practices (EBP) for the management of Alzheimer's disease and agitation among LTC staff; and (b) to evaluate the contribution of demographic and attitudinal variables to LTC staff beliefs about these EBP. Method A cross sectional study of 371 LTC staff members completed an EBP questionnaire, a short demographic questionnaire, and an attitudinal questionnaire about AD and agitation. Results Paraprofessional caregivers, those of lower educational level, and ethnic minorities were more likely to be in disagreement with the EBP views examined in this study. Those in disagreement with the EBP views also reported a preference towards not working with residents with AD and agitation and a sense of helplessness associated with such work. Disagreement with EBP views was associated with both normalization and stigmatization of AD and agitation. Conclusions Paraprofessional caregivers, ethnic minorities, and people of lower educational level are most at need for educational activities about AD and neuropsychiatric symptoms. Educational efforts geared towards changing the belief system of LTC staff should target not only EBP but also information about AD and agitation as conditions that are deviant from the normal aging process, yet non-stigmatizing. It is expected that following EBP will empower staff and improve staff motivation to work with residents with AD and agitation.
We demonstrate the use of behavioral techniques with older adults in long-term care settings, using two case examples. Ms. N is an 81-yearold woman with mild cognitive impairment who attended 12 sessions of problem-solving therapy for ongoing depression. Her Montgomery Asberg Depression Rating Scale score of 30 (moderate levels of depression) decreased to 6 (not depressed) following treatment. Mr. K is a 77-year-old male with moderate to severe Alzheimer's disease who was referred for treatment of behavioral problems. Following 10 weeks of restraint free environment, his Cohen Mansfield Agitation Inventory score declined from 60 (moderate behavioral problems) to 38 (minimal problem behaviors), indicating a significant reduction in agitation. Through these two cases, we provide a description of Downloaded by [University of Tasmania] at 03:48 14 October 2014 78 L. Ayalon et al. behavioral interventions for the treatment of depression and behavioral problems in long-term care settings.
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