| Behavioral Interventions
Operant conditioning, which involves reinforcement to decrease, increase or shape a behavior, may be helpful for managing behavioral problems related to dementia. Such reinforcement may include teaching a new behavior that will make the undesirable one less likely to occur, distracting the patient during an undesirable behavior, or praising the patient for appropriate behavior. Antecedent modification changes the stimulus that provokes the undesirable behavior.
Several cognitive techniques are used in dementia therapies:
Reality Orientation (RO) was first developed in the 1960s as a technique to improve the quality of life of confused elderly people, although its origins lie in an attempt to rehabilitate severely disturbed war veterans. It is thought to provide the patient with a greater understanding of his or her environment, possibly resulting in an improved sense of control and self-esteem. There has been criticism of RO with the suggestion that it has been applied in a mechanical fashion and has been insensitive to the needs of the individual or that is contributes to feelings of disempowerment. For more information about clinical evidence for Reality Orientation see: Cochrane Library Review Abstract by A. Spector, M. Orrell, S. Davies and R.T. Woods.
Reminiscence/life review encourages the person to recall events from his or her life, either silently or vocally, alone, or in a group with other participants. It involves regular meetings in which participants are encouraged to talk about past events, with the assistance of memory aids such as photographs, music or objects from relevant time periods. For more information about clinical evidence for Reminiscence Therapy see: Cochrane Library Review Abstract by A. Spector, M. Orrell, S. Davies and R.T. Woods.
Validation Therapy (VT) attempts to understand the meaning underlying the individual behaviors and was developed by Naomi Feil, a gerontological social worker. VT attempts to communicate with a disoriented person by validating and respecting their feelings in whatever time or place is real to them at the time, whether or not it corresponds to the "here and now". For more information about clinical evidence for VT see: Cochrane Library Review Abstract by M. Neal and M. Briggs.
Disclaimer: Always seek the advice of a physician or other health care provider when considering an intervention. Many of these interventions can only be done by trained professionals.
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