Treating excess disabilities in special care units: A review of interventions

Martichuski, Diane K.; Bell, Paul A.

doi:10.1177/153331759300800504

Cited by 8 publications

(6 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If too much is done for a patient, however, the patient's functional level is decreased below what is possible, creating an excess disability. 9 Programs designed to stimulate remaining cognitive abilities have been shown to maintain cognitive and behavioral functioning and improve emotional functioning. 10…”

Section: Problems With the Medical Model Of Carementioning

confidence: 99%

An Interdisciplinary Dementia Program Model for Long-Term Care

Warchol¹

2004

Topics in Geriatric Rehabilitation

View full text Add to dashboard Cite

An emerging area for geriatric rehabilitation specialists is in dementia care in long-term care facilities. With a high percentage of residents affected by Alzheimer's disease and related disorders, the skills of physical, occupational, and speech therapists can be used to assess cognition and function and to implement programs that allow cognitively impaired residents to maximize their remaining capabilities and avoid excess (unnecessary) disability, and thus improve their quality of life. Residents with mild dementia can learn new skills. This article presents an interdisciplinary model based on a theoretical foundation, using the theory of retrogenesis, developed by Dr Barry Reisberg, and the Allen cognitive disabilities theory, developed by Claudia Allen, OTR/L. Examples of components of the "Forget-Me-Not" dementia program developed by the author are given.A N emerging area in health care is dementia management. Dementia management consists of a finely orchestrated, goaldirected interdisciplinary program addressing the unique needs of the dementia resident. All team members work together towards a broad common goal of enabling the resident with dementia to achieve maximum functioning, safety, and well-being, for an effective program. This article will focus on the role of the interdisciplinary team in long-term care in improving function and quality of life for the person with dementia. OCCURRENCE AND TYPES OF DEMENTIAIn the past, the word senility was often used to describe "confusion"in the elderly. As research has advanced, the broad term senility has become outdated and replaced with more descriptive terms such as "age-related " and "dementia." Dementia indicates the presence of a pathological process causing changes in the brain that impact a person's ability to function independently. There are several different conditions and diseases with dementia symptoms. Alzheimer's disease is the most common dementing disease seen in the elderly, affecting about 60% of all people with the diagnosis of dementia. Degenerative changes in the brain lead to problems with short-term memory, learning and retention of new information, problemsolving, spatial orientation, and language ability. Changes in personality, mood, and behavior are very common. 1 Multi-infarct or vascular dementia represents 10% to 20% cases of dementia, and is recognizable by the presence of focal neurological signs and a stepwise progression of symptoms. Early gait changes at onset with a history of multiple cerebrovascular accidents (CVAs) are signs that may assist in differentiating vascular dementia. Risk factors are hypertension or coronary artery disease. Dementia with Lewy bodies accounts for 20%. The early symptoms of dementia with Lewy bodies are not memory problems, as seen in Alzheimer's disease, but impairments with attention, logical thinking, and spatial and time peceptions. There are fluctuations in memory and cognition that are not seen in 59

show abstract

Section: Problems With the Medical Model Of Carementioning

confidence: 99%

An Interdisciplinary Dementia Program Model for Long-Term Care

Warchol¹

2004

Topics in Geriatric Rehabilitation

View full text Add to dashboard Cite

show abstract

“…A general clinical observation is that the more dementia patients are involved in appropriate activities, the less they are involved in inappropriate activities. Martichuski and Bell (1993) provided a brief review of literature on special care units that suggested that programs designed to encourage patients to operate at their highest level of functioning show a decrease in patient behavior problems.…”

Section: Activitiesmentioning

confidence: 99%

“…A dementia patient who is confronted with too much to do or a task that is too difficult is likely to respond with what is called a catastrophic reaction. On the other hand, if caregivers do too much for patients or fail to facilitate patients' independence, a condition referred to as excess disability is created (Martichuski & Bell, 1993).…”

Section: Activitiesmentioning

confidence: 99%

“…Personality characteristics and behavior problems that emerge during the course of dementia may be totally unlike the premorbid characteristics of the person, but it is an easy mistake to assume that all aspects of a dementia patient are due to the dementia rather than to premorbid characteristics of the person. Clinical experience shows that understanding and management of behavior problems is often facilitated by an understanding of earlier personality, habits, hobbies, problem-solving styles, and occupation (Martichuski & Bell, 1993). In a similar manner, research has linked premorbid personality to behavior problems in dementia patients (Hamel et al, 1990; Holst, Hallberg, & Gustafson, 1997; Kolanowski, Strand, & Whall, 1997).…”

Section: Relevant Personal Historymentioning

confidence: 99%

“…If too much is demanded of a patient, a catastrophic reaction or other behavior problem may result. If too much is done for a patient, the patient's functional level is decreased beyond possible levels, creating an excess disability (Martichuski & Bell, 1993). Programs designed to stimulate remaining cognitive abilities have been shown to maintain cognitive and behavioral functioning and improve emotional functioning (Quayhagen & Quayhagen, 1989).…”

Section: Level Of Cognitive Functioningmentioning

confidence: 99%

See 2 more Smart Citations

Behavior management planning for problem behaviors in dementia: A practical model.

Slone¹,

Gleason²

1999

Professional Psychology: Research and Practice

View full text Add to dashboard Cite

Psychologists are often sought out by families or nursing home staff to develop intervention strategies for behavior problems in dementia patients. This article describes a systematic approach, or practical model, for developing these strategies. Variables that may contribute to behavior problems include comfort needs, assaultiveness, anger, patient's perceptions, activity involvement, triggers, patterns of escalation, personal history, caregiver interaction styles, and level of cognitive functioning. Each variable of this model is described in terms of key team members, relevant team dynamics, assessment, and intervention strategies.Psychologists are being increasingly called on to help develop intervention strategies for behavior problems in dementia patients (Nordhus, VandenBos, Berg, & Fromholt, 1998). The need for psychological intervention begins with the realization that "The dementias are the most commonly found psychiatric syndromes in the nursing home with a prevalence of 67 to 78 percent" (Grossberg & Solomon, 1993, p. 35). The behavior problems of dementia patients constitute a disproportionate part of the caregiving burden. As a result, the management of these behavior problems is primarily left to nursing assistants, who often have little or no formal training in working with behavioral problems (Liptzen, 1992). Given these considerations, the need for involvement of psychologists becomes clear. This article describes a practical model that psychologists can use to guide their assessment and intervention efforts directed toward behavior problems in dementia patients.It may be initially tempting to look for specific approaches to specific problems. For example, one may ask how to manage assaultiveness, wandering, disruptive vocalizations, or inappropriate sexual behavior. Indeed, a number of authors have offered recommendations to manage specific behavior problems. These strategies tend to be either behavioral, environmental, or some combination of these techniques (e.g.,

show abstract

Autonomy-supportive environments for people with dementia: an evidence-based review

2023

Interdisciplinary Nursing Research

View full text Add to dashboard Cite

Objective: As one of the core principles of person-centered care, supporting the autonomy of residents with dementia has received increasing attention worldwide. Supportive physical environments play an important role in promoting autonomy in the everyday life of residents in care facilities. However, there is no universal definition for autonomy in everyday life nor focused research on autonomy-supportive environments. Thus, this study aims to systematically review the existing evidence of autonomy-supportive design features based on a synthesized concept analysis of autonomy in everyday life. Methods: A synthesized concept analysis on autonomy was conducted based on related definitions of autonomy in design guidelines and environmental assessment tools of elderly care facilities. Using keywords from the concept analysis, multiple databases including PubMed, Web of Science, CINAHL, PsycINFO, and Dementia Design Info were used to carry out a systematic review of autonomy-supportive environmental design features for people with dementia. Additional guidelines and standards were manually searched. The design features supported by empirical studies and studies based on experts’ experience were extracted from the literature. The evidence intensity of each feature was assessed according to the quality and quantity of related studies. Results: Four domains of autonomy, freedom, independence, control, and choice emerged based on the concept analysis. Seventy-eight autonomy-supportive design features were extracted from the literature. Features are summarized into 8 categories: building layout, circulation space, living room, dining space, bathroom, bedroom, outdoor space, and details. Of design features, 60% in the category of building layout have been cross-validated by empirical studies, whereas only 25% of the overall design features have. Conclusions: The results of this review show that numerous design features of the physical environment can support the autonomy of people with dementia in the 4 domains. Features of building layout are well researched and the evidence intensity for the rest of design features still needs to be improved through future empirical studies.

show abstract

Treating excess disabilities in special care units: A review of interventions

Cited by 8 publications

References 19 publications

An Interdisciplinary Dementia Program Model for Long-Term Care

An Interdisciplinary Dementia Program Model for Long-Term Care

Behavior management planning for problem behaviors in dementia: A practical model.

Autonomy-supportive environments for people with dementia: an evidence-based review

Contact Info

Product

Resources

About