| The
Geriatric Mental Health Training Series:
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.
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.
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.
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.
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.
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.
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.
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