Managing Problem Behaviors in Dementia by Enhancing Memory and Communication Skills

Memory loss is one of the most pervasive and debilitating symptoms of dementia, including Alzheimer's disease. It can be exhibited in a variety of ways, such as losing things around the house; failing to recognize places visited or getting lost on a walk; rambling, irrelevant conversations, forgetting or confusing recent past events, a story, or detailed instructions; and repeating the same questions. Michelle Bourgeois, Ph.D., at the University of Pittsburgh, has developed and evaluated a variety of strategies designed to help individuals with dementia to function better in their daily lives. She has found that by providing memory aids and a prosthetic environment in which stimuli and consequent events are carefully planned to evoke and reinforce appropriate functional behavior, patients with dementia have increased desired and decreased undesirable behaviors.

Dr. Bourgeois has investigated a variety of memory aids, including memory wallets, memory books, memo boards, and cue cards. Because these aids are usually portable and personalized, they help the person remember better, just as other prosthetic devices such as glasses, hearing aids, canes, and dentures help people to see, hear, walk, and eat better. She has received funding from the Alzheimer's Association in Chicago and the National Institute on Aging to evaluate the effects of these types of memory aids on conversational and other memory-related behaviors of patients with dementia and their caregivers.

Delawareans will have a chance to learn from Dr. Bourgeois at a DATI-sponsored workshop on February 2, 1995. This session, to be held from 9:00-noon at Westminster Presbyterian Church on Pennsylvania Ave. in Wilmington, is being offered free of charge to caregivers and service providers concerned about the impact of memory loss in the daily lives of people with Alzheimer's disease and other dementias. Based on results of studies conducted in patients' homes, adult day care centers, and nursing homes, Dr. Bourgeois will present memory aid strategies that have proven to improve stimulation, orientation, and conversational content and to decrease sundowning behaviors, anxiety, and repetitive questions. Other general behavior management principles and strategies that focus on the verbal and non-verbal communication skills of family and staff will be discussed. The audience is encouraged to suggest for discussion problem behaviors that have been particularly resistant to their remediation efforts.