HCGNE - The Geriatric Mental Health Training Series (Six Topics)

Six Core Topics

The six-part training program developed and evaluated by Buckwalter, Smith and colleagues is revised by Smith and provided here by the HCGNE. Each module listed below is designed to be taught as a one-hour educational program for care providers in long-term care settings. The six core topics address common problems faced in LTC settings. Each is designed to help staff be more knowledgeable about the causes of "problem behaviors" and about techniques to manage those troubling behaviors. The care providers' own feelings and behaviors in response to problem behaviors is examined, including the role of values and beliefs, personal needs, and stress in the work place.

In this revision, the dementia program is separated into two modules to allow adequate time to discuss both characteristics of dementia (Part I) and interventions to promote more adaptive behavior (Part II). By title and description, the core modules include the following programs.

• Whose Problem Is It? -- Mental Health and Illness in Long-term Care

Mental illness is a common problem among nursing home residents, and a primary cause of behavioral management problems for staff. However, threats to mental health may also precipitate behavioral problems. Both types of problems are briefly reviewed in this introductory program. An emphasis is placed on accurate identification of the underlying causes of the difficult behavior, and on the staff's management of their own feelings about problem behaviors.

• Getting the Facts -- Effective Communication With Older Adults

Long-term care personnel may overlook various barriers to effective communication with older adults and consequently misinterpret verbal and behavioral messages. General principles of the communication process are reviewed with an emphasis placed on problems created by sensory changes, staff attitudes and beliefs, and various types of disease that may affect the residents. Strategies to promote more effective communication are offered.

• Help, Hope, and Power -- Issues of Control and Power in the Long-term Care Center

The problem behaviors often observed in lucid residents (those without dementia) may be associated with feeling "out of control" due to the many losses that are encountered in late life. Factors that may contribute to difficult behaviors are considered and strategies to increase a sense of control through "doing, thinking, and acting" are considered.

• When You Are More Than Just Down in the Dumps -- Depression in Older Adults

Depression is more common in older people than is often realized. The failure to recognize this treatable illness may lead to unnecessary suffering. This program provides participants with an overview of the signs and symptoms of depression, common problems that cause or mimic depression, and ways to assist elderly who may be depressed.

• When You Forget That You Forgot -- Recognizing and Managing Alzheimer's Type Dementia, Part I

Alzheimer's disease and other dementias are commonly encountered in the long-term care setting. However, staff frequently misinterpret or misjudge behaviors and abilities due to lack of knowledge about the extent and nature of lost abilities. This program provides an overview of various types of dementia, but focuses on Alzheimer's' Disease (A.D.). The stages of A.D. are reviewed, including common behavioral problems associated with each. The Progressively Lowered Stress Threshold (PLST) model of care is introduced as a model to help caregivers reduce stress and promote more functional behavior in dementia.

• When You Forget That You Forgot -- Recognizing and Managing Alzheimer's Type Dementia, Part II

This program builds on information provided in Part I of the two-part series, focusing on basic interventions that may be used to prevent, reduce and manage behavioral symptoms that may occur in AD and other types of dementia. Interventions based on the PLST model of care are reviewed, along with strategies to promote more effective communication and methods to manage “simple” delusions or time confusion.

• Back to the A-B-C's -- Understanding & Responding to Behavioral Symptoms in Dementia

Behavioral and psychological symptoms of dementia are often puzzling, and sometimes are troubling to staff, other residents and family members alike. Compassionate and effective care relies on understanding the problem from the perspective of the person with dementia and accurately assessing a diverse array of factors that may cause or contribute to behavioral symptoms. In this module, the Antecedent-Behavior-Consequence (ABC) model is applied to the care of persons with dementia. By assessing and changing common antecedents (triggers) and consequences (reactions), caregivers are often able to promote comfort and function for individuals with dementia.