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