Increasing conversations between older adults with dementia using textual stimuli.

Dementia often leads to behavior changes such as deficits in communication and social interaction; one effective antecedent strategy for improving communication involves rearranged or supplemental stimuli. In the present study, researchers placed individualized textual prompts on the dinner table of three women at an assisted-living facility. Textual stimuli included prompts such as "Debbie, ask Pat where she liked to travel," and led to increases in conversation duration. The results suggest that antecedent interventions can improve social interactions for individuals with dementia with minimal involvement of caregivers.Textual prompts may improve social communication between individuals with dementia.Salient stimuli, such as participants' names, may be necessary to facilitate conversation.The textual intervention requires minimal training and response effort from caregivers and care staff.Improvements in conversation duration maintained at 6 months post-study.

A systematic review of strategies to foster activity engagement in persons with dementia.

Dementia is a growing public health issue. Activity, a positive therapeutic modality, has potential to enhance quality of life and reduce behavioral symptoms in persons with dementia--outcomes eluding pharmacological treatments. However, it is unclear how to effectively engage persons with dementia in activities for them to derive desired benefits. We present a systematic review of 28 studies involving 50 tests of different ways of modifying activities to enhance engagement and reduce behavioral and psychological symptoms for this group. Of 50 tests, 22 (44%) evaluated changes to objects and properties (e.g., introducing activities with intrinsic interest), 6 (12%) evaluated changes to space demands (e.g., lighting, noise levels), 8 (16%) evaluated changes to social demands (e.g., prompts, praise), and 14 (28%) combined two or more activity modifications. No modifications were made to the sequence and timing of activities. Although modifications to objects and properties were the most common, outcomes for engagement and behaviors were mixed. Modifications to space and social demands were less frequently tested, but consistently yielded positive outcomes. No modifications resulted in negative behavioral outcomes or decreased engagement. Methodological strengths of studies included direct observation of outcomes and fidelity assessments. Few studies however involved persons with dementia at home. Our review revealed a growing evidentiary base for different modifications to foster engagement in activities and reduce behavioral and psychological symptoms. Future studies should evaluate how contextual factors (e.g., physical environment, activity type) and caregiver ability to employ activity modifications affect engagement.

Training and maintenance of a picture-based communication response in older adults with dementia.

We examined whether adults with dementia could learn to emit a picture-based communication response and if this skill would maintain over time. Three women with moderate to severe dementia were taught to exchange a picture card for a highly preferred activity. All participants quickly learned to exchange the picture card and maintained this response without practice.

An evaluation of procedures to increase cooperation related to hoarding in an older adult with dementia.

The prevalence of hoarding (collection of and refusal to discard unneeded items) is higher in older adults than the general population and has been correlated with dementia. Treatments to increase cooperation with discarding hoarded items have not been systematically evaluated. This study evaluated two procedures for increasing cooperation with handing over hoarded items in an older adult with dementia. The antecedent-based intervention effectively increased cooperation.

Behavior-analytic research on dementia in older adults.

It is estimated that 1 in 10 adults aged 65 years and older have been diagnosed with dementia, which is associated with numerous behavioral excesses and deficits. Despite the publication of a special section of the Journal of Applied Behavior Analysis (JABA) on behavioral gerontology (Iwata, 1986), there continues to be a paucity of behavior-analytic research with this population. This review compares the research published before and after the behavioral gerontology special section and evaluates the most recently published aging articles in JABA.