Although researchers stress the importance of encouraging independent behavior in persons with dementia, institutional practices often foster dependence. This study took place in a six-resident locked dementia care unit that followed the common institutional practice of serving meals on prepared plates. The purpose of this study was to examine if changing the mode of meal delivery to "family-style," where residents were presented with serving bowls and empty plates, would increase resident communication and participation in mealtime tasks. An ABAB' reversal design revealed very low rates of appropriate communication (5% of intervals) and mealtime participation (10% of tasks) during baseline, when residents received prepared plates (A). Communication and participation doubled when family-style meal delivery was introduced (B) and dropped back to baseline levels when it was withdrawn (A). Because the levels of communication and participation during family-style meals were still low, the nursing assistant was provided with instruction on prompting and praising appropriate mealtime behaviors (B'). After instruction was provided and family-style meals were reintroduced, resident participation rose to 65% of tasks and appropriate communication increased to 18% of observations. This study suggests family-style meals may result in modest increases in mealtime participation and communication of residents with dementia, but staff training in prompting and praising may be necessary to see large changes in these behaviors.
Wandering away from home, or elopement, is a behavior that places persons with dementia at risk of serious injury and may lead family caregivers to place their loved ones in institutions or to severely restrict their independence. Funding from the National Institute on Aging (NIA) was used to evaluate the Mobile Locater, an electronic device designed to help caregivers quickly locate a person who has eloped. This 6-month pilot study included case studies of seven users and an opinion survey of family caregivers, professional caregivers and search and rescue workers. The survey results showed that respondents were positively impressed by the device, only identifying cost as a potential drawback. Case studies revealed that the equipment was easy to use, effective, and helpful to caregivers' peace of mind. These results suggest that the Mobile Locater is a valuable tool deserving of further study.
This study analyzed the effects of nursing assistants' use of prompts and praise to increase the engagement of older adults with dementia in daily living activities. The multiple baseline design across morning and afternoon work shifts showed consistent increases in engagement by each of the 5 residents during the intervention. These results suggest that increasing prompts and praise by nursing assistants may, in turn, increase the rate of engagement of older adults with dementia.
This paper addresses B. F. Skinner's utopian vision for enhancing social justice and human wellbeing in his 1948 novel, Walden Two. In the first part, we situate the book in its historical, intellectual, and social context of the utopian genre, address critiques of the book's premises and practices, and discuss the fate of intentional communities patterned on the book. The central point here is that Skinner's utopian vision was not any of Walden Two's practices, except one: the use of empirical methods to search for and discover practices that worked. In the second part, we describe practices in Skinner's book that advance social justice and human well-being under the themes of health, wealth, and wisdom, and then show how the subsequent literature in applied behavior analysis supports Skinner's prescience. Applied behavior analysis is a measure of the success of Skinner's utopian vision: to experiment.
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