4/21/2015 1 4/21/2015 2 What are Plaques & Tangles? Most people develop some of these as we age. Those with Alzheimer’s develop far more: Plaques: Clusters of beta amyloid protein build up between nerve cells & may lead to brain cell death. Tangles: Strands of a tau protein, collapse and tangle together & may lead to brain cell death. 4/21/2015 3 The Goal of Habilitation Therapy (HT) Promote a positive emotion in the person with dementia •Focus on their strengths •Minimize their limitations 4/21/2015 4 Habilitation not Rehabilitation! • Rehabilitation Therapy: – Help a person to re‐learn abilities they’ve lost • Habilitation Therapy: –Helps a person with dementia use remaining abilities & skills. – We do not focus on their limitations or try to teach them what they’ve lost 4/21/2015 5 Habilitation Therapy Communication the Physical Environment Behavior as Communication Mrs. Mary Lopez Purposeful Engagement 4/21/2015 our Approach to Personal Care 6 The Goal of Habilitation Therapy (HT) Promote a positive emotion in the person with dementia •Focus on their strengths •Minimize their limitations 4/21/2015 7 Habilitation Therapy • Communication – words, body language and non‐verbal communication – is very important • the Environment makes a big difference for the person with dementia • • Our Approach to Care always starts with the person • Activity and Purposeful Engagement give the person with dementia a sense of purpose and belonging Behavior as Communication. When speaking is difficult, behavior becomes the way to communicate 4/21/2015 8 What if you saw this? 4/21/2015 9 What if this was the reason? 4/21/2015 10 BEHAVIORAL ANALYSIS PROTOCOL STEPS IN WRITING A BEHAVIOR PLAN Paul Raia, PhD • Statement of the problem • State who has been informed of this problem and how you are meeting regulatory standards in your immediate response to the problem • State the goal of the plan • Describe the behavior (detailed description not interpretation) Note that the description of the behavior is not always the same as the problem ie, John yells (behavior), others are agitated (problem) • Note any observed patterns in the behavior attained in the behavioral log • State a working hypothesis as to the cause (trigger(s) of the behavior • Describe the intervention in detail and how it might involve staff on all shifts, and if relevant the family or authorized person(s) • State who will be responsible for the overall application/oversight of the intervention plan 4/21/2015 11 • Who will implement the intervention on each shift • Who will chart the implementation of the intervention and how often • Indicate if a behavioral log will be used to observe the intervention • If anyone needs to be trained in order to implement the intervention, who will be trained; who will deliver that training; and when will it be completed • State the duration of the intervention • Who will inform authorized family/guardian and medical professionals that the behavior plan is in progress • State when the team will meet over the intervention period and who will convene this meetings • What percentage of the behavior do you anticipate the intervention will address 4/21/2015 12 • State what percentage of the remaining behavior would be acceptable (if any) and how you plan to address the remaining behavior • Indicate the date(s) when the team will meet to assess intervention outcomes and what measures (methods) will be used to assess the outcomes • Who will write the report of the intervention outcomes, enter the report into the chart, and inform all authorized parties • When will the team meet again to evaluate if the plan needs to be changed • Enter the behavior plan and outcomes into the care plan • If the intervention was determined to be unsuccessful, the team should meet to discuss why the plan failed and consider the relevance of other behavioral triggers and a new intervention strategy 4/21/2015 13
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