PhysicalTherapy.com Phone: 866-782-6258


Care Models Addressing Behaviors in Persons With Dementia

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS

February 28, 2020

Share:

Question

Can you explain the two care models that address behaviors in persons with dementia?  

Answer

The first is the Progressively Lowered Stress Threshold Model.  According to this model, adults are less able to manage stress as the disease progresses.  Their threshold for stress is lower thus resulting in anxiety and dysfunctional behaviors.  Stressors include fatigue; changes in routine, caregiver or environment; demands that exceed their ability; multiple and competing stimuli; perception of loss; physiologic factors such as pain, illness, discomfort or medication side effects. 

It is based on six principles of care: Modify the environment to ensure safety, provide unconditional positive regard, use anxiety as a gauge of activity and stimulation levels, teach the caregiver(s) to listen for behaviors, modify the environment to support losses and enhance safety, and provide education and support to the caregiver(s).

The second model is called the Need-Driven Dementia-Compromised Behavior Model.  Developed in 1993, this model changes the view that behaviors are disruptive and instead are needs that, if responded to correctly, can enhance the quality of life.  Behaviors are a result of “background” factors and “proximal” factors.  Background factors, which are stable individual and disease-related characteristics include: dementia compromised functioning (language issues, memory, etc),  poor overall health status, demographic variables (e.g., marital status), psychosocial variables (e.g., personality traits)

Proximal factors, meaning those inducing a need state include unmet physiologic needs, unmet psychological needs (e.g., contact with family), disturbing environmental factors (e.g., cold room), and uncomfortable social surroundings (e.g., too many people in the room).

It is the proximal factors that we can control and those that will guide our interventions.

 


kathleen d weissberg

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS

In her 30+ years of practice, Dr. Kathleen Weissberg has worked in rehabilitation and long-term care as an executive, researcher, and educator.  She has established numerous programs in nursing facilities; authored peer-reviewed publications on topics such as low vision, dementia quality care, and wellness; and has spoken at national and international conferences. She provides continuing education support to over 40,000 individuals nationwide as National Director of Education for Select Rehabilitation. She is a Certified Dementia Care Practitioner, a Certified Montessori Dementia Care Practitioner, and a Certified Fall Prevention Specialist.  She serves as the Region 1 Director for the American Occupational Therapy Association Political Action Committee and adjunct professor at Gannon University in Erie, PA. 


Related Courses

Put Down the Drugs: Evidence-Based Interventions to Reduce Unwanted Behaviors with Dementia
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #3072Level: Intermediate1 Hour
  'Good information'   Read Reviews
PTs can apply evidence-based interventions to improve dementia care. This session reviews the etiology of common behaviors. Cognitive-emotion, multi-sensory, animal-assisted, and exercise interventions to reduce agitation are discussed as well as specific strategies for improving task-related engagement. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Supporting the LGBTQ Senior in Healthcare
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #4096Level: Intermediate2 Hours
  'The instructor was clear and experienced and had interesting anecdotes to share/illustrate the concepts'   Read Reviews
This training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Supervising Assistants, Students, and Aides: Upholding Your Ethics in a Challenging Health Care Environment
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #4377Level: Intermediate2 Hours
  'She spoke clearly and concisely'   Read Reviews
This presentation reviews the definitions of supervision as well as APTA guidance related to supervising assistants, students, and aides in various healthcare environments. Documentation guidelines for Medicare are reviewed as these relate to what an assistant can complete versus a therapist. The use of students and rehab aides in long-term care is reviewed in accordance with Medicare guidelines. Real examples of common supervisory ethical dilemmas from the field, including the appropriate action steps to take in each one, are highlighted. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA

Dementia Management: Techniques for Staging and Intervention
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #3649Level: Intermediate2 Hours
  'Personal relevance with practical suggestions and approaches'   Read Reviews
This seminar provides an overview of types of dementia including characteristics at each stage, protocols for staging clients with dementia and related treatment strategies. Documentation and treatment planning based on dementia staging results is reviewed. Behavior management and communication strategies for this population are discussed as well as techniques for nursing to follow. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Bullying Among Older Adults: Not Just a Playground Problem
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #4692Level: Introductory1 Hour
  'This course gave me alot of context in what to look for and how to provide intervention in bullying situations in senior care'   Read Reviews
In this session, participants learn the definition and incidence of bullying in adult living communities and day centers, including what older adult bullying looks like in this population. Characteristics of older adult bullies, as well as their targets and gender differences, are explored. The reasons why bullying occurs, as well as the five different types of bullies, are defined. Interventions for the organization, the bully, and the target are reviewed to help communities minimize (and prevent, where possible) bullying and mitigate the effects on the target. Addressing bullying behavior among older adults is critically important for enhancing the quality of life and promoting emotional well-being; strategies to create caring and empathic communities for all residents and staff members are reviewed.

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.