Interdisciplinary development and implementation of a dementia skills training program in a VA community living center: a pilot study.

This pilot study investigates the usefulness of a dementia care training program developed by an interdisciplinary team to address problem behaviors associated with dementia. Staff members of a VA Community Living Center completed an 8-hour workshop covering fundamental knowledge about dementia and instruction in skills to use with patients through video, lecture, and role-plays. Measures on dementia knowledge and perceived self-efficacy were completed by staff members before and after the workshop. Results revealed increases in self-efficacy and knowledge, with particular gains in general knowledge of dementia and communicating with patients. Younger staff members scored higher on tests of knowledge at pre- and post-test, whereas staff members with more years of work experience rated their self-efficacy higher at post-test only. There was an associated decrease in assaultive behaviors by patients with dementia in the year this workshop was implemented. Results highlight the benefit of interdisciplinary collaboration in developing educational content and the value of providing staff training on managing dementia-related behaviors. Adjustments to this training program are discussed.

Swimming against the Tide: A Case Study on the Removal of Conservatorship and Guardianship.

OBJECTIVE: This article evaluates the role healthcare providers play in balancing safety versus autonomy among elders when performing capacity evaluations. METHODS: Presentation of a case study consisting of an 85-year-old, Caucasian, widowed, male, post-stroke veteran, residing in long-term care. He was assigned a permanent court-appointed joint guardian and conservator, but wanted to remove both of these as he felt he had the ability to manage his own affairs. This case study specifically addresses the issue of financial capacity. RESULTS: After completion of the evaluation, a case was made for the least restrictive means balancing patient autonomy and protection, opting for a limited conservatorship. The court, using the evaluation as evidence, completely removed the guardianship and conservatorship. CONCLUSIONS: This article outlines how providers can navigate multiple roles, team dynamics, and advocate for enhancing the capacity of an older adult.

Probabilistic thinking and death anxiety: a terror management based study.

Terror Management Theory has been utilized to understand how death can change behavioral outcomes and social dynamics. One area that is not well researched is why individuals willingly engage in risky behavior that could accelerate their mortality. One method of distancing a potential life threatening outcome when engaging in risky behaviors is through stacking probability in favor of the event not occurring, termed probabilistic thinking. The present study examines the creation and psychometric properties of the Probabilistic Thinking scale in a sample of young, middle aged, and older adults (n = 472). The scale demonstrated adequate internal consistency reliability for each of the four subscales, excellent overall internal consistency, and good construct validity regarding relationships with measures of death anxiety. Reliable age and gender effects in probabilistic thinking were also observed. The relationship of probabilistic thinking as part of a cultural buffer against death anxiety is discussed, as well as its implications for Terror Management research.