How to manage behavioral problems

2021 ◽  
pp. 109-130
Author(s):  
Andrew E. Budson ◽  
Maureen K. O’Connor
Keyword(s):  
Behavior Change ◽  
Behavioral Problems ◽  
Good News ◽  
Loved One ◽  
Know How ◽  
Dangerous Situation ◽  
Power Tools

Behavioral problems are among the most difficult ones you may face caring for your loved one with dementia. The good news is that there are many approaches you can use to reduce unwanted behaviors and encourage positive ones. Conquer apathy with routines. Sidestep willfulness with small steps. Use the ABCs of Behavior Change, 4Rs, and Three Time Principles to manage agitation, aggression, combativeness, and inappropriate/disinhibited behavior. Stay safe by giving away or securing guns, power tools, and knives. Remember to call for help or leave a dangerous situation when you need to. Know how to stay safe in the car when you’re driving, and stop your loved one from driving when necessary. Deal with sundowning and challenging interactions outside of the home. Manage jealousy and paranoia. Finally, consider helping your loved one to feel more comfortable with soothing and familiar music, pleasing scents, stuffed animals, and real or robotic pets.

How to manage behavioral problems

2021 ◽  
pp. 109-130
Author(s):  
Andrew E. Budson ◽  
Maureen K. O’Connor
Keyword(s):  
Behavior Change ◽  
Behavioral Problems ◽  
Good News ◽  
Loved One ◽  
Know How ◽  
Dangerous Situation ◽  
Power Tools

Behavioral problems are among the most difficult ones you may face caring for your loved one with dementia. The good news is that there are many approaches you can use to reduce unwanted behaviors and encourage positive ones. Conquer apathy with routines. Sidestep willfulness with small steps. Use the ABCs of Behavior Change, 4Rs, and Three Time Principles to manage agitation, aggression, combativeness, and inappropriate/disinhibited behavior. Stay safe by giving away or securing guns, power tools, and knives. Remember to call for help or leave a dangerous situation when you need to. Know how to stay safe in the car when you’re driving, and stop your loved one from driving when necessary. Deal with sundowning and challenging interactions outside of the home. Manage jealousy and paranoia. Finally, consider helping your loved one to feel more comfortable with soothing and familiar music, pleasing scents, stuffed animals, and real or robotic pets.

scholarly journals Behavior Change Theories: a New Medical Education Paradigm?

2020 ◽  
Vol 44 (4) ◽  
Author(s):  
Leonardo Essado Rios
Keyword(s):  
Medical Education ◽  
Behavior Change ◽  
Behavioral Problems ◽  
Theoretical Models ◽  
Explanatory Models ◽  
Teaching Profession ◽  
Evidence Based ◽  
Motivation To Change ◽  
New Paradigm ◽  
Behavior Change Theories

Abstract: A critical perspective on the importance of evidence-based behavior change theories for medical education is presented. Numerous theoretical models have been proposed to explain behavior changes, with two theories currently emerging as a new paradigm, namely the Behaviour Change Wheel (BCW) and the Prime Theory of Motivation. Behind this is the fact that these theories were proposed based on comprehensive literature review about explanatory models of behavioral changes, in addition to consensus among experts. The basic principle is that any change in behavior necessarily involves three interrelated aspects: capability, opportunity, and motivation. In the present essay, these theories were addressed with a view to problems involving behaviors in medical education, and emphasis on the problem of obsolete teaching practices in the training of health professionals. Assuming that good teachers have a global view of the teaching profession, and not merely of their specialty, interventions to change outdated teaching performances among health educators should start by understanding their motivation to change. It is also necessary to investigate their knowledge and skills about innovative teaching-learning methods (capability), as well as whether the environment supports methodological diversification and innovation (opportunity). In summary, evidence-based behavior change theories may represent a new paradigm for medical education when the goal involves overcoming behavioral problems.

Which medications can improve thinking, memory, behavior, or function?

2021 ◽  
pp. 181-202
Author(s):  
Andrew E. Budson ◽  
Maureen K. O’Connor
Keyword(s):  
Clinical Trials ◽  
Behavioral Problems ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Beta Blockers ◽  
Serotonin Reuptake Inhibitors ◽  
Atypical Neuroleptics ◽  
Loved One ◽  
With Memory ◽  
Over Time

Dementia disrupts a number of brain chemicals, and medications may be helpful to restore the balance of these neurotransmitters. When considering a new medication, it is important to set clear, measurable goals; start with a low dose; and track the effects over time. Cholinesterase inhibitors help with memory, mood, behavioral problems, and hallucinations; memantine helps with attention, alertness, mood, and behavioral problems; selective serotonin reuptake inhibitors (SSRIs) help with mood, anxiety, and behavioral problems; dextromethorphan/quinidine helps with inappropriate laughing or crying as well as behavioral problems; melatonin and acetaminophen help with sleep; atypical neuroleptics help with agitation, aggression, delusions, hallucinations, and picking; carbidopa/levodopa helps with walking, movement, and parkinsonian tremors; and beta blockers help with essential tremor. Clinical trials of new medications being developed may be available for those who are looking for better treatments for their loved one and for the next generation.

Why is it important to sustain your relationship?

2021 ◽  
pp. 239-248
Author(s):  
Andrew E. Budson ◽  
Maureen K. O’Connor
Keyword(s):  
Behavioral Problems ◽  
Loved One

Despite the challenges of dementia, it is important to continue to have fun with your loved one and nurture your relationship. Engaging in pleasant activities is a great way to remain connected. These activities can also help to reduce behavioral problems, boost mood, and even improve functioning in your loved one. Engaging in activities with your loved one can also help reduce burden and stress on you. Although your loved one may have trouble doing some of the things they enjoyed before their dementia, there are a variety of activities that they can still participate in. Some activities may be variations on things they used to enjoy and others may be entirely new. We encourage you to take time to engage in pleasant activities with your loved one on a regular basis.

Why is it important to sustain your relationship?

2021 ◽  
pp. 239-248
Author(s):  
Andrew E. Budson ◽  
Maureen K. O’Connor
Keyword(s):  
Behavioral Problems ◽  
Loved One

Despite the challenges of dementia, it is important to continue to have fun with your loved one and nurture your relationship. Engaging in pleasant activities is a great way to remain connected. These activities can also help to reduce behavioral problems, boost mood, and even improve functioning in your loved one. Engaging in activities with your loved one can also help reduce burden and stress on you. Although your loved one may have trouble doing some of the things they enjoyed before their dementia, there are a variety of activities that they can still participate in. Some activities may be variations on things they used to enjoy and others may be entirely new. We encourage you to take time to engage in pleasant activities with your loved one on a regular basis.

Transitioning to Fixed-Route Services

1998 ◽  
Vol 1623 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Carol R. Denson
Keyword(s):  
United States ◽  
Americans With Disabilities Act ◽  
Safety Net ◽  
The United States ◽  
Transportation Systems ◽  
Good News ◽  
Core Group ◽  
Know How ◽  
Special Services ◽  
The Cost

By 2002, it is expected that all fixed-route transportation systems in the United States will be accessible to people with disabilities. This is heralded as good news for riders who have been limited to traveling via special services (i.e., paratransit) and transit providers concerned with the cost of such services. Such optimism assumes—perhaps erroneously—that many riders will shift from paratransit to the newly accessible fixed-route systems. A survey was conducted that reveals that riders are generally satisfied with the service they receive and—despite imminent accessibility—are not eager to switch. The paratransit service, which the Americans with Disabilities Act (1990) regards as a “safety net” for those unable to use fixed-route transit, has become the primary mode of public transport for significant portions of its ridership. However, a core group of riders appears to be interested in changing, which, coupled with the finding that almost none of the survey respondents had received any form of travel training, suggests that there is cause for measured optimism. In addition to training, accessibility must be considered in systemic terms, built on the requirements that riders know how to use the fixed-route system and can get to and from buses, they believe they are welcome in the system, and they understand the costs and consequences of using paratransit. These results are achievable by educating riders, transit staff, and the general public. In addition, there needs to be informed manipulation of fixed routes.

SFBT and Evidence-Based Practice

2017 ◽  
Author(s):  
Johnny S. Kim ◽  
Michael S. Kelly ◽  
Cynthia Franklin
Keyword(s):  
Mental Health ◽  
Behavioral Problems ◽  
Evidence Based Practice ◽  
Federal Agencies ◽  
Good News ◽  
Deficit Thinking ◽  
Evidence Based ◽  
School Settings ◽  
Empirically Supported ◽  
State Of The Science

This chapter offers an up-to-date survey of the best available evidence for SFBT. There is a lot of good news here for SFBT practitioners and researchers alike. First of all, as this chapter amply demonstrates, SFBT has been increasingly shown to be an effective treatment for a range of mental health and behavioral problems and is now listed as an evidence-based practice by federal agencies like Substance Abuse Mental Health Service Administration (SAMHSA). Additionally, the research base for SFBT as an evidence-based practice in school settings is also growing, indicating that SFBT is a workable and empirically-supported alternative to other approaches that are more driven by deficit thinking and labeling of students. This chapter outlines the “state of the science” for this exciting approach.

Bereaved Family Members’ Views of the Value of Coronial Inquests Into Fatal Work Incidents

2018 ◽  
Vol 82 (3) ◽  
pp. 446-466 ◽  
Author(s):  
Mark Ngo ◽  
Lynda R. Matthews ◽  
Michael Quinlan ◽  
Philip Bohle
Keyword(s):  
United Kingdom ◽  
Family Members ◽  
Common Theme ◽  
Institutional Response ◽  
Loved One ◽  
Know How ◽  
The United Kingdom ◽  
Bereaved Family ◽  
Sense Of Justice

Fatal work incidents result in an array of government responses, and in countries such as the United Kingdom and Australia, this may include the holding of coronial inquests. A common theme from the scant literature is that family members have a strong need to know how and why their loved one died. The inquisitorial nature of inquests suggests potential in uncovering this information, although little is known about families’ experiences with these proceedings. Interviews with 40 bereaved relatives explored their views and experiences of inquests. Findings suggest that families, often frustrated with other investigative processes, want inquests to provide a better understanding of how and why the death occurred, uncover any failings/responsibilities, and thereby move closer to a sense of justice being obtained for the deceased. Families identified problems perceived to impair the process and where improvements could be made to secure a more effective and meaningful institutional response to the fatality.

Which medications can improve thinking, memory, behavior, or function?

2021 ◽  
pp. 181-202
Author(s):  
Andrew E. Budson ◽  
Maureen K. O’Connor
Keyword(s):  
Clinical Trials ◽  
Behavioral Problems ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Beta Blockers ◽  
Serotonin Reuptake Inhibitors ◽  
Atypical Neuroleptics ◽  
Loved One ◽  
With Memory ◽  
Over Time

Dementia disrupts a number of brain chemicals, and medications may be helpful to restore the balance of these neurotransmitters. When considering a new medication, it is important to set clear, measurable goals; start with a low dose; and track the effects over time. Cholinesterase inhibitors help with memory, mood, behavioral problems, and hallucinations; memantine helps with attention, alertness, mood, and behavioral problems; selective serotonin reuptake inhibitors (SSRIs) help with mood, anxiety, and behavioral problems; dextromethorphan/quinidine helps with inappropriate laughing or crying as well as behavioral problems; melatonin and acetaminophen help with sleep; atypical neuroleptics help with agitation, aggression, delusions, hallucinations, and picking; carbidopa/levodopa helps with walking, movement, and parkinsonian tremors; and beta blockers help with essential tremor. Clinical trials of new medications being developed may be available for those who are looking for better treatments for their loved one and for the next generation.

scholarly journals Treatability Statements in Serious Illness: The Gap Between What is Said and What is Heard

2019 ◽  
Vol 28 (3) ◽  
pp. 394-404 ◽  
Author(s):  
JASON N. BATTEN ◽  
BONNIE O. WONG ◽  
WILLIAM F. HANKS ◽  
DAVID C. MAGNUS
Keyword(s):  
Quality Of Life ◽  
Empirical Work ◽  
Good News ◽  
Shared Decision ◽  
Conversational Implicature ◽  
Intended Meaning ◽  
Loved One ◽  
Serious Illness ◽  
Treatable Condition

Abstract:Empirical work has shown that patients and physicians have markedly divergent understandings of treatability statements (e.g., “This is a treatable condition,” “We have treatments for your loved one”) in the context of serious illness. Patients often understand treatability statements as conveying good news for prognosis and quality of life. In contrast, physicians often do not intend treatability statements to convey improvement in prognosis or quality of life, but merely that a treatment is available. Similarly, patients often understand treatability statements as conveying encouragement to hope and pursue further treatment, though this may not be intended by physicians. This radical divergence in understandings may lead to severe miscommunication. This paper seeks to better understand this divergence through linguistic theory—in particular, H.P. Grice’s notion of conversational implicature. This theoretical approach reveals three levels of meaning of treatability statements: (1) the literal meaning, (2) the physician’s intended meaning, and (3) the patient’s received meaning. The divergence between the physician’s intended meaning and the patient’s received meaning can be understood to arise from the lack of shared experience between physicians and patients, and the differing assumptions that each party makes about conversations. This divergence in meaning raises new and largely unidentified challenges to informed consent and shared decision making in the context of serious illness, which indicates a need for further empirical research in this area.

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