Dementia Care: Basic Behavior management advisory service program
BBAS Program Proposal
Introduction
The basic behavior advisory service (BBAS) is a special program for adults and families living with dementia which can be deemed a necessity. The program is objectified at offering behavioral advisory services through the utilization of ICT based innovative technologies and solutions. The simple solutions to the program can include calling and texting support services for information and advice on strategies to deal with certain behavioral changes among adults living with dementia. The main focus is to significantly improve and reinforce the independence, participation and access to care for families and adults living with the disease. The program is set to inform families on newly identified and proper ways to effectively manage the behavior of people with dementia and in turn, reduce their dependency level. This is particularly aimed for those without access to respite care and an alleviated level of dependency.
The ICT solutions such advisory services offered through a smart phone and tablet application will be fashioned in a way that effectively reduces cost for both the end user and provider. Also, the application will be customized in such a way that it can track the progression of behavior changes in the patient through provision of memory stimulating and multicolored games. The establishment of a call center will provide free call services for families to assist in providing information on effective ways to properly manage the behavior of their family members living with the disorder. The call center shall be used to disseminate information on therapeutic and compensatory measures for these families and provide adequate information for their effective application. Therefore, the program will be open to all candidates despite the level of care needed for them. In this regard, a care needs assessment or evaluation is not focused at determining eligible candidates for the program but provide more personalized information that is customized to the level of care and need for the families and adults living with the disorder.
Rationale
Dementia is a slow, degenerative and perpetual permanent decline in brain function. The condition can be characterized by a multiplicity of symptoms which constitute challenges in language, perception, memory, personality changes and a reduction in the cognitive skills of an individual. Dementia is caused by one or an amalgamation of many known causes with the most common being the onset of Alzheimer’s disease and vascular causes. The progression of the disease can be characterized into four phases:
- The onset of difficulties- early stages
- Progression of significant difficulties in the day-to-day living of an entity
- Alleviated dependency on family and other supportive social and medical structures
From this, it can be gathered that many persons with dementia progress to a stage where they require care and support at home to assist them to improve their lives well with the disorder. The support structure for a person suffering with dementia is significant in improving the quality of their lives. Therefore, families who care for an individual with dementia may require help or support to carry out their role. Professionals and persons suffering from dementia report that there are significant challenges in accessing appropriate care and support for entities living with Dementia. Folks living with dementia are at times turned away from respite care services because their overly dependent and hence, their care needs are too high.
The rehabilitation of people living with dementia can be attributed to cognitive changes and the loss of memory accrued to the malady. The three primary concerns in the care and support services of the individuals include: –
- The magnitude to which new learning is deemed possible such that new techniques, therapeutic or compensatory approaches and most especially those that connote behavioral changes to address both functional and performance difficulties can be introduced and properly implemented.
- The effective ways to deal with dementia-related behavior that can interfere with the therapeutic processes and the quality of life of people living with the disease
- The proper strategies aimed at involving family members in the therapeutic process to ensure maximization of benefits towards persons living with the disease.
Therefore, an advisory management service is well placed to mitigate some of the issues highlighted. Reinhard et al. highlight that most dementia patients have some form of family support care and this “informal care” can be significant is scope, intensity and duration (Reihard, Barbara and Petlick 1). Along these lines, it can cause safety concerns through the following ways (Reihard, Barbara and Petlick 1): –
- Caregivers are often referred to as secondary patients and thus, need all the protection and guidance they can get. It is from the fact that they are susceptible to injury or adverse events.
- The caregivers are unpaid and hence, need help to get acquainted with how to become more effective or competent and augment safety for the patient and other family members.
It can be highlighted that adults and particularly older people run the risk of poor results or outcomes when admitted to the acute care setting as a consequence of comorbidity and mismanagement of their chronic confusion. Therefore, interventions are necessary to improve and reduce the burden of care and such can be ensuring access to skilled expertise and education. Globally, there is a rise in dementia incidences especially in developed nations in Europe, Australia and the United States. Therefore, it has resulted on restricted access and financial concerns in effectively funding dementia case interventions. The progression of the disease alleviates the level of dependency which might prove costly for any institution to manage. The special BBAS program is a step towards mitigating such costs by delivering professional advice and expertise to victims and families with dementia. The dissemination of information also empowers the family volunteers to effectively offer to dementia care which can be considered to be a substitute to respite services such as daycare offered to some adult dementia patients.
Goals of the program
The BBAS program offers great capacity to support not only the individuals living with dementia to live accordingly but also their families, informal and professional caregivers. The promotion of ICT solutions can help in facilitating the program and widen its scope. It can play a role in the detection, prevention, intervention and self-management. The BBAS program can be accrued to the following objectives:
- The goal of the program underlies the provision of behavior management advisory services through ICT or technology and call centers to reduce the burden of care and stress among the informal caregivers. The BBAS also invokes to use the technology to communicate with adult dementia patients, emotional and psychosocial support by professionals, and access to information and education for the informal caregivers.
- The program also aims to alleviate coordination of care between professionals and informal caregivers and improve the patient’s environment through education and sensitizations.
- For facilitating the provision of new interventions and therapeutic measures matured for patients and proper application procedures.
- To ensure the improvement of life for the dementia patient regardless of being eligible for respite care services such as day care offered discriminatively by government institutions and hospitals.
Staff involved in the program
Psychologists
The psychologists will be responsible for giving end-of-life counseling services and performing assessments for mild cognitive impairment. The qualifications of the psychologist would be a minimum of a diploma in the field with at least four years of experience.
Geriatrician
The employee is required to provide expert evaluation and unique dementia presentations. In extension, provide special expertise as regards behavioral symptoms. He or she is also required to provide continuous support to the patient or family of dementia patients. The minimum requirement for the job is a degree in the field with at least two years’ experience in a related field (Alzheimer’s Society).
Social Workers
The professional will be responsible for link informing on the community resources to address the unmet needs for informal caregivers. It will extend to establishing and facilitating caregiver support groups in the different localities. The position will be open to individuals who have worked with hospitals and other governmental institutions as regards dementia patient care.
Occupational Therapists
The occupational therapists are aimed to examine the functional performance of the patients through a series of tests and assessments. It is aimed at establishing the kind of assistance, compensatory approach and environmental modifications required to successfully complete daily activities. The employee is responsible for offering trainings in communication and stress-reduction styles to care givers. The qualifications underlie a related degree to the profession and a minimum of three years’ experience.
Call Care Center Staff
The call care staff will be recruited from different healthcare professionals. They will be taken through a rigorous training program as regards dementia care, behavior management interventions and approaches.
ICT Staff
The staff will be professional Information technology and computer science graduates. They will be charged with maintaining the applications and maturing new technologies fashioned at improving the BBAS program.
Coordination of Services
Dementia is a sophisticated disease and evaluations, assessments, interventions and caregiver support can be more effective when the healthcare system utilizes an integrated, inter-professional strategy in dementia care. The inter-professional teams work together and use their expertise and experiences to mature an integrated approach to comprehending and treating the individual with the disorder. The BBAS program shall implement such an approach to ensure the dissemination of sound advice, evaluations, training and information relayed to the patients and informal caregivers. The teams are motivated to communicate and establish a shared understanding aimed at achievement of the set goals.
Pre-service and In-service Training
Studies conducted have shown that provision of training both pre-service and in-service augments the level of care and improve the quality of life of a dementia care patient. The pre-service trainings conducted should be aligned to the guidelines of the Alzheimer’s Association. The in-service trainings are set to improve and work of the ideals of personalized care.
Limitations
Consumer Participation
It can be highlighted that the design of programs is restricted by the fact that the target audience is not engaged in the implementation of policies and procedures. Also, the influences of dementia on an individual vary and the term used to describe a multiplicity of maladies or disorders. There lacks complete information about the services present in the market by different care providers. Therefore, determining the success of the project is a hard task. Nonetheless, the suitability of the project is evident from the growing numbers of dementia care patients such that the respite services offered do not suffice.
Lack of specialized support
The BBAS program is mostly grounded on the notion of provision of expert and skillful support to the patients and informal caregivers. There lacks a steady supply of such staff in the labor market which is a challenge for the program. The BBAS program is designed and intends to be marketed on the principle of 24-hour support from the experts (through a smartphone/tablet application and call center) and hence, it necessitates the need to have qualified professionals. There is a perceived lack of structure as concerns training and knowledge dissemination in dementia care.
Target audience
A considerable proportion in the United States is challenged with the condition dementia; this is especially the elderly people who are usually retirees living on state pension plans. According to the APA, approximately 5.4 million people live with dementia in the United States; one in three senior citizens dies due to dementia related causes (Huntsman and Huntsman 23).
BBAS is looking to redefine the statistics and accord quality care giving to all patients. Care givers from patient families spend amounts that surpass $5000 on an annual basis in their efforts to care for an individual living with dementia (Caddell and Clare 379-398). With such a predisposition, this may mean missing a vacation while for other families it may mean going hungry. The American Psychological Association has projected that in the course of the year 2016, America will have to spend 236 billion USD to cater for all dementia related expenses.
The BBAS is going to focus on improving patient care, paying professional caregivers for the number of hours they will dedicate to patient care, and offering financial treatment plans for patient families that cannot afford medication and therapy. Being a for-profit organization, the BBAS is looking to realize improved health care for patients living with dementia and also make sufficient profit for the overall growth and development of the institution. The population the BBAS is looking to target as potential clients include individuals of age 55 and above; this is because most reported cases of dementia fall within this age group (Psychcentral 1).
In America, most patients, that is, adult citizens living with dementia have no access to respite care services. The BBAS program is looking to accord some health care solutions to such patients. The program has found out that lack of funds has been a challenge to some families living with dementia patients. What’s more, some patients, mostly senior citizens, have been neglected by their children who may be living in other states or even abroad. Nonetheless, the primary target of the BBAS program constitutes the adult patients who have been locked out of respite services and informal care givers charged with the responsibility of taking care of these patients.
The BBAS i.e. Basic Behavior Advisory Service has taken it upon itself to seek out these patients with the help of locals; the program has created community awareness and will urge all people to become good neighbors and make an anonymous phone call if they happen to be living in proximity with a neighbor that is suffering from mental illness and who is without care.
Effectiveness of Pharmacological Approaches
The BBAS is very much aware of the need to utilized conventional medicine as a primary way of treating mental patients suffering from dementia. In as much as care giving is a very vital part of tending to the needs of patients, it only comes as a secondary necessity that supplements the administration of drugs which slowly suppress the condition and at times predispose patients to “near recovery conditions”(Henderson and Guitierrez-Mayka 59-74).
As above mentioned, therapy is an important part of treating a severe mental condition like dementia but its importance does not supersede the relevance of drugs. With respect to a pharmacological approach, there are many drugs in the United States that have garnered the approval of the FDA; these include cholinesterase inhibitors, that is, ChEIs or mermantine. It is worth mentioning that administration of these kinds of drugs usually takes a period of 12 months. BBAS commends the placement of drugs and therapy on an equal footing for the best results when it comes to the recovery of patients.
Effectiveness of behavior management
The lack of suitable environmental conditions is what acts as a precursor to unhealthy mental conditions (Jenkins and McKay 49-57). With such a reality, it is only fair that individuals diagnosed with dementia live in stress-free surroundings that will eventually promote their full recovery. Sources of stressful environments that initially lead to dementia include jobs that are very demanding, family responsibilities, using of drugs, worries such as midlife crisis, social isolation, and incarceration among others.
For all patients attended to by BBAS facilities to realize an improved quality of life there is a need for exposure to serene environments. The psychiatrist dealing with such a patient ought to be friendly; what’s more primary care giving should be accorded by family members or health professionals that are considerate and mindful of the patient’s condition. With dementia treatment plans, the brain should only focus on recovering basic sensory and motor skills; in addition to that, there is a need for the patients to recover their long term and short term memories alike.
The proper management of behavior takes the corporation of the family members and the clinical psychologist dealing with the patient living with dementia. According to American Psychiatric Association, problem behavior in life can be attributed to undesirable outcomes, problems at work, drug abuse, and involvement in criminal activities (Kaiser and Panegyres 398-402).Behavior management services are meant to assist dementia patients to realize and maintain conduct that is pro social among their peers. All the interventions applied in clinical treatments and care giving at home by family members and/or paid nurses conventionally includes ways of addressing the challenge of noncompliance at work places, aggressive conduct, breaking of rules, delinquent conduct, and general disruptive behavior. The most common intervention methods used comprise two basic models i.e. family centered and home centered programs; all these are dependent on express permissions from clinical psychologists.
Above all, behavioral management services are traditionally delivered via personal care plans grounded upon proper clinical assessment stipulations. Instances of specified behavior management treatment of patients suffering from dementia includes finding out the antecedents of undesirable conduct, utilization of motivating factors in reinforcements, coming up with plans to take care obvious problem behaviors, bringing together intervention methods across a number of different settings, and offering proper training to all caregivers (usually family) in a patient’s life to take care of all dementia behavior goals (Llanque and Enriquez 23-32). A close knit working relationship between psychiatrists dealing with dementia patients and care givers is bound to bring about the much needed success in the health and general well-being of any given patient. Slow recovery of patients results from a lack of understanding and patience on the part of caregivers. In as much as there is a lot of responsibility that comes from spending a lot of time with patients, care givers ought to understand the limitations that come with dementia and the constraints it places on the overall normalcy of those suffering from the condition.
Market and Advertising
The target market for BBAS comprises the entirety of all dementia patients in the United States. With the approval of the APA, the establishment is very much befitting when it comes to according patient care to all patients that visit their facilities (“Symptoms of Dementia – Dementia Guide – NHS Choices” 1).
When it comes to advertising, the organization will use both traditional and new media. Traditional media will center on print media and television while new media advertising. The main aim of the advertising initiatives taken by BBAS will be to create awareness of the service. When target markets are aware of the initiative’s programs, they are bound to visit the BBAS clinics in all the states where they will be found; realizing a patient centered approach through efficient dementia care programs. The tag line for the advertisement will be: “Get in touch with the experts, know how to deal.” The brand personality is intended to be subtle, calm and educated.
BBAS Budget
| Characteristic | Projected Costs |
| Registrar of Companies | $ 10,000 |
| Creation of an Application- BBAS Secure and customized tablets and smart phones | $ 500000 |
| Equipment | $ 355,000 |
| Labor | $630,000 |
| Miscellaneous | $ 6000 |
| Grand Total | 2,338,000 |
Financing
The program targets mostly patients who cannot access respite services from other providers. It aims at broadening the scope of care for these individuals and provisions of solutions for informal care givers. It is inclusive of arranged trainings and social programs aimed at connecting suffering adult patients and caregivers together for informative and motivational forums. The program intends to reduce costs to dementia care whilst improving availability.
The financing is expected to come from:
- Donors and non-governmental organizations
- Donations from the public
- Local community dementia organizations
- Chur
Works Cited
Alzheimer’s Society. “Dementia 2014 Infographic – Text Only Version – Alzheimer’s Society”. Alzheimer’s Society. N.p., 2014. Web. 3 Jan. 2016.
Brooker, Dawn. Person-Centred Dementia Care. London: Jessica Kingsley Publishers, 2007. Print.
Caddell, L. S. and L. Clare. “I’m still the same person: The Impact of Early-Stage Dementia On Identity”. Dementia 10.3 (2011): 379-398. Web.
“Dementia Statistics | Alzheimer’s Disease International”. Alz.co.uk. N.p., 2015. Web. 11 Mar. 2015.
Henderson, J. Neil and Marcela Guitierrez-Mayka. “Ethnocultural Themes in Caregiving To Alzheimer’s Disease Patients In Hispanic Families”. Clinical Gerontologist 11.3-4 (1992): 59-74. Web.
Huntsman, Mark and Mark Huntsman. “How A Virtual Reality Forest Helps Alzheimer’s Patients”. Alzheimers.net. N.p., 2014. Web. 11 Mar. 2015.
Jenkins, Catharine and Ailsa McKay. “A Collaborative Approach To Health Promotion In Early Stage Dementia”. Nursing Standard 27.36 (2013): 49-57. Web.
Kaiser, S. and P. K. Panegyres. “The Psychosocial Impact Of Young Onset Dementia On Spouses”. American Journal of Alzheimer’s Disease and Other Dementias 21.6 (2007): 398-402. Web.
Llanque, S. M. and M. Enriquez. “Interventions For Hispanic Caregivers Of Patients With Dementia: A Review Of The Literature”. American Journal of Alzheimer’s Disease and Other Dementias 27.1 (2012): 23-32. Web.
Psychcentral.Dementia Word Hand. Web. 7 Jan. 2016.
Reihard, Susan, et al. “Patient safety and quality: An evidence-based handbook for nurses.” Agency for healthcare and quality research (US) (2008). Online. <https://www.ncbi.nlm.nih.gov/books/NBK2665/>.
“Symptoms of Dementia – Dementia Guide – NHS Choices”. NHS UK. N.p. 2015. Web. 21 Dec. 2015.
“This Is What Your Brain Looks Like with Alzheimer’s Disease”. Iflscience.com. N.p., 2015. Web. 11 Mar. 2015.