Behavioral Interventions and Families: A Medical Rehabilitation Perspective
Tóm tắt
Behavioral interventions are pertinent to many issues faced by medical rehabilitation patients and their families in late adulthood. Despite their utility in managing chronic illnesses and reducing problematic behaviors related to cognitive impairment, behavioral interventions can be difficult to implement and maintain in a family setting. Problems resulting from countercontrol, caregiver fatigue, conflicting priorities, and impact on family relationships must be anticipated and addressed. These issues are illustrated through references to pertinent research and case examples. Recommendations are offered to reduce caregiver stress and to minimize shifts in relationships when family caregivers act to alter a member's behavior.
Tài liệu tham khảo
Allen, K., Linn, R. T., Gutierrez, H., and Willer, B. S. (1994). Family burden following traumatic brain injury. Rehab. Psychol. 39: 29–48.
American Academy of Orthopaedic Surgeons (1996). Live it Safe, American Academy of Orthopaedic Surgeons, Des Plaines, IL.
American Heart Association (2000). Older Americans and cardiovascular diseases: Biostatistical fact sheets [Online]. Available at: ww.americanheart.org/statistics/biostats/biool.htm
Baer, D. M., Wolf, M. M., and Risley, T. R. (1968). Some current dimensions of applied behavior analysis. J. Appl. Behav. Anal. 1: 91–97.
Beck, A. T. (1996). Beck Depression Inventory-II, Psychological Corporation, San Antonio.
Brehm, J. W. (1966). A Theory of Psychological Reactance, Academic Press, New York.
Burgio, L. D. (1991). Behavioral staff training and management in geriatric long term care facilities. In Wisocki, P. A. (ed.), Handbook of Clinical Behavior Therapy With the Elderly Client, Plenum Press, New York, pp. 423–438.
Desai, M. M., Zhang, P., and Hennessy, C. H. (1999). Surveillance for morbidity and mortality among older adults—United States, 1995- 1996. MMWR CDC Surveill. Summ. 48(8): 7–25.
Ferrucci, L., Guralnik, J. M., Pahor, M., Corti, M. C., and Havlik, R. J. (1997). Hospital diagnoses, Medicare charges, and nursing home admissions in the year when older persons become severely disabled. JAMA 277: 728–734.
Fordyce, W. E. (1976). Behavioral Methods for Chronic Pain and Illness, Mosby, St. Louis.
Goldstein, F. C., Strasser, D. C., Woodard, J. L., and Roberts, V. J. (1997). Functional outcome of cognitively impaired hip fracture patients on a geriatric rehabilitation unit. J. Am. Geriatr. Soc. 45: 35–42.
Gosling, J., and Oddy, M. (1999). Rearranged marriages: Marital relationships after brain injury. Brain Inj. 13: 785–796.
Kemp, B. J. (1988). Eight methods family members can use to manage behavioral problems in dementia. Top. Geriatr. Rehab. 4: 50–59.
Liptzin, B., Grob, M. C., and Eisen, S. V. (1988). Family burden of demented and depressed elderly psychiatric inpatients. Gerontologist 28: 397–401.
Logsdon, R. G., Teri, L., McCurry, S. M., Gibbons, L. E., Kukull, W. A., and Larson, E. B. (1998). Wandering: A significant problem among community-residing individuals with Alzheimer's disease. J. Gerontol. B Psychol. Sci. Soc. Sci. 53B: P294–P299.
Logsdon, R. G., Teri, L., Weiner, M. F., Gibbons, L. E., Raskind, M., Peskind, E., Grundman, M., Koss, E., Thomas, R. G., Thal, L. J., and members of the Alzheimer's Disease Cooperative Study (1999). Assessment of agitation in Alzheimer's Disease: The Agitated Behavior in Dementia Scale. J. Am. Geriatr. Soc. 47: 1354–1358.
Mace, N. L., and Rabins, P. V. (1981). The 36-Hour Day, Warner Books, New York.
Manton, K. G., Corder, L. S., and Stallard, E. (1993). Estimates of change in chronic disability and institutional incidence and prevalence rates in the U.S. elderly population from the 1982, 1984, and 1989 National Long Term Care Survey. J. Gerontol. 48: S153–S166.
Miller, L. K. (1991). Avoiding the countercontrol of applied behavior analysis. J. Appl. Behav. Anal. 24: 645–647.
Morris, E. K., Higgins, S. T., and Bickel, W. K. (1982). Comments on cognitive science in the experimental analysis of behavior. Behav. Anal. 5: 109–125.
National Center for Health Statistics. (1999). Health, United States, 1999, With Health and Aging Chartbook [On-line]. Available: www.cdc.gov/nchs/products/pubs/pubd/hus/hus.htm
Skinner, B. F. (1953). Science and Human Behavior, Macmillan, New York.
Skinner, B. F. (1971). Beyond Freedom and Dignity, Knopf, New York.
Teri, L. (1999). Training families to provide care: Effects on people with dementia. Int. J. Geriat. Psychiatry 14: 110–116.
Teri, I., Larson, E. B., and Reifler, B. V. (1988). Behavioral disturbance in dementia of the Alzheimer's type. J. Am. Geriatr. Soc. 36: 1–6.
Teri, L., Logsdon, R. G., Whall, A. L., Weiner, M. F., Trimmer, C., Peskind, E., Thal, L., and Alzheimer's Disease Cooperative Study (1998). Treatment for agitation in dementia patients: A behavior management approach. Psychotherapy 35: 436–443.
Teri, L., Truax, P., Logsdon, R., Uomoto, J., Zarit, S., and Vitaliano, P. P. (1992). Assessment of behavioral problems in dementia: The Revised Memory and Behavior Problems Checklist. Psychol. Aging 7: 622–631.
Weiner, M. F., Teri, L., and Williams, B. T. (1996). Psychological and behavioral management. In Weiner, M. F. (ed.), The Dementias: Diagnosis, Management, and Research, 2nd edn., American Psychiatric Press, Washington, DC, pp. 139–175.
Zarit, J. M., and Zarit, S. H. (1991). Behavioral programs for families of dependent elderly. In Wisocki, P. A. (ed.), Handbook of Clinical Behavior Therapy With the Elderly Client. Applied Clinical Psychology, Plenum Press, New York, pp. 439–458.
Zarit, S. H., and Zarit, J. M. (1998). Mental Disorders in Older Adults, The Guilford Press, New York.