scholarly journals It Has Not Been a Good Day: Managing Difficult Behaviors of Relatives With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 639-639
Author(s):  
Karen Roberto ◽  
Brandy Renee McCann ◽  
Tina Savla ◽  
Emily Hoyt ◽  
Rosemary Blieszner ◽  
...  
Keyword(s):  
Behavior Management ◽  
Service Providers ◽  
Management Strategies ◽  
Educational Interventions ◽  
Community Dwelling ◽  
Behavior Understanding ◽  
Supportive Environment ◽  
Memory Problems ◽  
Appropriate Care ◽  
With Memory

Abstract Most family caregivers provide appropriate care and a supportive environment for their older relatives with dementia (PwD), yet the stress and strain associated with caregiving can trigger potentially harmful responses. Although much has been written about dealing with memory problems, researchers know less about how caregivers cope with difficult behaviors such as hallucinations, violent outbursts, or refusing food, medicine, or bathing. Interviews with 30 relatives providing care to community-dwelling PwD in rural Virginia revealed that caregivers typically used four behavior management strategies: reasoning with PwD; redirecting PwD’s attention; forceful actions, such as shouting at PwD; and withdrawing from interactions. Forceful management strategies and withdrawing from interactions were usually employed after reasoning and redirection failed to elicit desired behavior. Understanding whether caregivers’ expectations of PwD’s capacities are realistic, and why and when caregivers use various behavior management strategies, can help service providers develop appropriate educational interventions for frustrated caregivers.

scholarly journals Unmet care needs are common among community-dwelling older people with memory problems in Finland

2019 ◽  
pp. 140349481989080 ◽  
Author(s):  
Mari S. Aaltonen ◽  
Lina H. Van Aerschot
Keyword(s):  
Home Care ◽  
Older People ◽  
Home Care Services ◽  
Community Dwelling ◽  
Care Needs ◽  
Care Services ◽  
Memory Problems ◽  
More Care ◽  
Community Dwelling Older People ◽  
With Memory

Aims: Ageing in place has become a policy priority. Consequently, residential care has been reduced, and more older people with multiple care needs reside at home with the help of informal care and home care services. An increasing share of these people has memory disorders. We examined the extent to which memory problems, in addition to other individual characteristics, are associated with unmet care needs among community-dwelling older people. Methods: The study employed cross-sectional survey data from community-dwelling people aged 75+ collected in 2010 and 2015, analysed using binary logistic regression analysis. The study population consisted of people who had long-term illnesses or disabilities that limited their everyday activities ( N = 1928). Nine per cent reported substantial memory problems. Of these, 35.7% had a proxy respondent. Results: People with memory problems have more care needs than those with other types of disability or illness. They receive more care but still have more unmet needs than others. About a quarter of people with memory problems reported that they did not receive enough help. This result did not change significantly when the proxy responses were excluded. Even a combination of informal and formal home care was insufficient to meet their needs. Conclusions: Insufficient care for people with memory problems implies a serious demand for further development of home care services. The care needs of this population are often complex. Unmet needs represent a serious risk to the well-being of people with memory disorders, and may also create an extensive burden on their informal caregivers.

The management of risk in a dryland environment

2011 ◽  
pp. 13-21
Author(s):  
D.I. Gray ◽  
J.I. Reid ◽  
D.J. Horne
Keyword(s):  
Risk Management ◽  
Service Providers ◽  
Management Strategies ◽  
Subterranean Clover ◽  
Farming Systems ◽  
Market Risk ◽  
Farm Size ◽  
Forage Crops ◽  
Risk Management Strategies ◽  
Upside Risk

A group of 24 Hawke's Bay hill country farmers are working with service providers to improve the resilience of their farming systems. An important step in the process was to undertake an inventory of their risk management strategies. Farmers were interviewed about their farming systems and risk management strategies and the data was analysed using descriptive statistics. There was considerable variation in the strategies adopted by the farmers to cope with a dryland environment. Importantly, these strategies had to cope with three types of drought and also upside risk (better than expected conditions), and so flexibility was critical. Infra-structure was important in managing a dryland environment. Farmers chose between increased scale (increasing farm size) and geographic dispersion (owning a second property in another location) through to intensification (investing in subdivision, drainage, capital fertiliser, new pasture species). The study identified that there may be scope for further investment in infra-structural elements such as drainage, deeper rooting alternative pasture species and water harvesting, along with improved management of subterranean clover to improve flexibility. Many of the farmers used forage crops and idling capacity (reduced stocking rate) to improve flexibility; others argued that maintaining pasture quality and managing upside risk was a better strategy in a dryland environment. Supplementary feed was an important strategy for some farmers, but its use was limited by contour and machinery constraints. A surprisingly large proportion of farmers run breeding cows, a policy that is much less flexible than trading stock. However, several farmers had improved their flexibility by running a high proportion of trading cattle and buffer mobs of ewe hoggets and trade lambs. To manage market risk, the majority of farmers are selling a large proportion of their lambs prime. Similarly, cattle are either sold prime or store onto the grass market when prices are at a premium. However, market risk associated with the purchase of supplements and grazing was poorly managed.

A Model for Addressing Crisis Behavior in Youth With Autism Spectrum Disorder Within a Functional and Contextual Framework

2020 ◽  
pp. 386-407
Author(s):  
Bryan H. King ◽  
Agnieszka Rynkiewicz ◽  
Małgorzata Janas-Kozik ◽  
Marta Tyszkiewicz-Nwafor
Keyword(s):  
Autism Spectrum Disorder ◽  
Behavior Management ◽  
Management Strategies ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Behavior Intervention Plan ◽  
Intervention Plan ◽  
Contextual Framework ◽  
Multiple Issues ◽  
Crisis Behavior

This chapter provides a model that extends the current resources available for crisis behavior assessment and intervention for youth with autism spectrum disorder (ASD) and co-occurring psychiatric conditions who are in crisis stabilization settings. Visual diagrams and intervention materials incorporated into this chapter illustrate the use of both preventative and responsive behavior management strategies that can be implemented in a time of crisis to stabilize and treat the psychiatric patient with ASD. The chapter begins with a review of a contextual method for evaluating and understanding the function of the presenting crisis behavior by considering the multiple issues that can underlie the crisis presentation. Working from this contextual model, the chapter then provides a blueprint for implementing intervention strategies to address crisis behaviors. This includes a table illustrating key elements to consider when developing a behavior intervention plan for dissemination and generalization.

scholarly journals Gentrification and Chronic Conditions in Older Adults: Service Providers’ Perspectives

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 341-341
Author(s):  
Ronica Rooks
Keyword(s):  
Older Adults ◽  
Online Community ◽  
Service Providers ◽  
Public Library ◽  
Community Dwelling ◽  
City Government ◽  
Property Taxes ◽  
Lower Socioeconomic ◽  
Community Information ◽  
Social Vulnerabilities

Abstract Where we live impacts our health, but this is more apt for older adults (aged 55+) aging-in-place in their neighborhoods. Gentrification, i.e. the transformation of neighborhoods from low to high value, can put community-dwelling older adults at risk for residential displacement with limited retirement incomes and financial stressors like increased housing costs and property taxes, residential turnover and changing access to resources. As a place-based stressor, gentrification may exacerbate social vulnerabilities (e.g., lower socioeconomic status and racial/ethnic minority status) related to chronic condition (CC) disparities. But, little gentrification research focuses on these issues. This research examines associations between gentrification and older adults’ CC management related to broader social determinants in Hamilton, Ontario, Canada from health and social service providers’ perspectives. Hamilton, a recovering steel industry city with in-migration from Toronto, is experiencing higher costs of living, income inequality and tension with recent gentrifiers. I conducted key informant interviews with service providers in city government and community-based organizations using thematic analysis. Across providers, food insecurity, social isolation and displacement were the biggest issues associated with gentrification and CC, particularly for older adults with lower incomes and government disability support. Results thus far reveal Hamilton has numerous older adult-focused providers, but older adults often have difficulties accessing services due to a lack of knowledge, not always asking or realizing when they need help and coordinated referral difficulties across providers. To address these challenges, providers consider environmental scans, mapping resources and advertisement in an online community information database from the city’s public library.

scholarly journals Role of caregiver factors in outpatient medical follow-up post-stroke: observational study in Singapore

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shilpa Tyagi ◽  
Gerald Choon-Huat Koh ◽  
Nan Luo ◽  
Kelvin Bryan Tan ◽  
Helen Hoenig ◽  
...  
Keyword(s):  
Observational Study ◽  
Management Strategies ◽  
Stroke Survivor ◽  
Stroke Survivors ◽  
Post Stroke ◽  
Memory Problems ◽  
Healthcare Needs ◽  
Stroke Study

Abstract Background Outpatient medical follow-up post-stroke is not only crucial for secondary prevention but is also associated with a reduced risk of rehospitalization. However, being voluntary and non-urgent, it is potentially determined by both healthcare needs and the socio-demographic context of stroke survivor-caregiver dyads. Therefore, we aimed to examine the role of caregiver factors in outpatient medical follow-up (primary care (PC) and specialist outpatient care (SOC)) post-stroke. Method Stroke survivors and caregivers from the Singapore Stroke Study, a prospective, yearlong, observational study, contributed to the study sample. Participants were interviewed 3-monthly for data collection. Counts of PC and SOC visits were extracted from the National Claims Database. Poisson modelling was used to explore the association of caregiver (and patient) factors with PC/SOC visits over 0–3 months (early) and 4–12 months (late) post-stroke. Results For the current analysis, 256 stroke survivors and caregivers were included. While caregiver-reported memory problems of a stroke survivor (IRR: 0.954; 95% CI: 0.919, 0.990) and caregiver burden (IRR: 0.976; 95% CI: 0.959, 0.993) were significantly associated with lower early post-stroke PC visits, co-residing caregiver (IRR: 1.576; 95% CI: 1.040, 2.389) and negative care management strategies (IRR: 1.033; 95% CI: 1.005, 1.061) were significantly associated with higher late post-stroke SOC visits. Conclusion We demonstrated that the association of caregiver factors with outpatient medical follow-up varied by the type of service (i.e., PC versus SOC) and temporally. Our results support family-centred care provision by family physicians viewing caregivers not only as facilitators of care in the community but also as active members of the care team and as clients requiring care and regular assessments.

scholarly journals The Use of Psychotropic Medication in Iranian Children with Developmental Disabilities

2021 ◽  
Vol 18 (8) ◽  
pp. 4120
Author(s):  
Roy McConkey ◽  
Sayyed Ali Samadi ◽  
Ameneh Mahmoodizadeh ◽  
Laurence Taggart
Keyword(s):  
Developmental Disabilities ◽  
Psychotropic Medication ◽  
Management Strategies ◽  
Educational Interventions ◽  
Autism Spectrum ◽  
Developmental Needs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Iranian Children ◽  
Children With Developmental Disabilities

The use of psychotropic medication in children is increasing worldwide. Children with developmental disabilities seem to be prescribed these medications at a higher rate compared to their non-disabled peers. Little is known about prescribing in non-Western, middle-income studies. In Iran, the file records of 1133 children, aged 2 to 17 years, assessed as having autism spectrum disorder (ASD) or an intellectual disability (ID) in Tehran City and Province from 2005 to 2019 were collated, and information from parental reports of medications was extracted. Upwards of 80% of children with ASD and 56% of those with ID were prescribed a psychotropic medication with around one quarter in each group taking two or more medications. The rates were higher among male children showing difficult-to-manage behaviors such as hyperactivity, but less so for children of fathers with higher levels of education. The lack of alternative management strategies may be a significant driver for the use of psychotropic medications in Iran and other Low and Middle Income countries, despite their known side effects, and their failure to address the developmental needs of the children. Rather, multi-disciplinary, behavioral, therapeutic, and educational interventions are required, but these are not available widely in Iran, although a start has been made.

Evaluation of increasing antecedent specificity in goal statements on adherence to positive behavior-management strategies

2016 ◽  
Vol 49 (4) ◽  
pp. 768-779 ◽  
Author(s):  
Corey M. Cohrs ◽  
Mark D. Shriver ◽  
Raymond V. Burke ◽  
Keith D. Allen
Keyword(s):  
Behavior Management ◽  
Management Strategies ◽  
Positive Behavior

Experience of family caregivers of community-dwelling stroke survivors and risk of elder abuse: a qualitative study

2014 ◽  
Vol 16 (5) ◽  
pp. 276-293 ◽  
Author(s):  
Celia Chow ◽  
Agnes Tiwari
Keyword(s):  
Qualitative Study ◽  
Family Caregivers ◽  
Local Community ◽  
Service Providers ◽  
Elder Abuse ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Content Type ◽  
The Disabled ◽  
Personal Resilience

Purpose – The purpose of this paper is to explore the following questions. First, what are the experiences of family caregivers in caring for community-dwelling stroke survivors? Second, what services help or do not help the caregivers in managing their caregiving role? Design/methodology/approach – A qualitative study was conducted with a total of six focus group interviews with 29 stroke caregivers selected using convenience sampling in a local community centre. All interviews were recorded and transcribed for content analysis. Findings – The results pointed to three main themes working together to facilitate desirable outcomes in caregiving and prevent elder abuse: factors contributing to caregiver stress and factors that have a buffering effect on caregiver stress and unmet needs identified from caregivers’ experiences. Research limitations/implications – The authors found that there were a number of factors contributing to caregiver stress. The findings matched with the concept that caregiver stress should not be considered as the primary cause of elder abuse. Findings provided information for further research to investigate positive coping and adjustment for stroke survivors, caregivers and their families. Practical implications – Policy makers and service providers may consider specific policies and tailor-made services to enhance the effectiveness of current practice. The themes emerging from the study could be further reviewed in a longitudinal way to explore the cost-effectiveness, the outcomes and trajectory of interventional programmes. Social implications – Education would be essential to let the public understand caregivers’ difficulties and needs. Prevention of elder abuse may be approached with a range of risk factors for both perpetrating and being elder abuse victim. Originality/value – From the findings of the study, the authors found that there were service gaps within policy and interventions. Concrete suggestions for improving the public's attitude and public facilities/transport for the disabled were captured in the study. In addition to personal resilience, caregivers had a strong wish for a supportive environment and services that would facilitate a better caregiving outcome.

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