Creating a healthy institutional environment for the elderly via behavior management: The nurse as a change agent

doi:10.1016/0020-7489(75)90003-6

International Journal of Nursing Studies

Volume 12, Issue 1, March 1975, Pages 5-12

https://doi.org/10.1016/0020-7489(75)90003-6 Get rights and content

Abstract

A single subject ABA reversal design was used in an attempt to change a chronic “screaming” behavior in an 80-yr-old nursing home resident. Two “therapeutic” contingencies were programmed simultaneously: (a) a positive reinforcement contingency (crf) using tangible as well as social reinforcers consequating the emittance of any desired “normal” behaviors was aimed at shaping and strengthening behaviors incompatible with screaming; and (b) a modified time-out contingency following immediately upon each screaming behavior was geared toward extinction of screaming behavior. Manipulation of the positive and negative consequences upon the occurrence of non-screaming and screaming behavior, respectively, resulted in the control of screaming behavior. Data are discussed in light of theoretical implications related to an ecological perspective towards aging as opposed to a biological perspective.

References (17)

W.S. Agras
Behavior modification: Principles and Clinical Applications
(1972)
T. Ayllon et al.
The psychiatric nurse as a behavioral engineer
J. exp. Anal. Behav.
(1959)
M. Baltes
Health care from a behavioral-ecological viewpoint
(1974)
E. Cumming et al.
Growing Old
(1961)
Th.J. De Carlo
Recreation participation patterns of successful aging
J. Gerontol.
(1974)
L.E. Gottesman
Milieu treatment of the aged in institutions
Gerontologist
(1973)
J.L. Grossman et al.
A token economy program on a mixed chronic and geriatric ward
W.J. Hoyer
Application of operant techniques to the modification of elderly behavior
Gerontologist
(1973)

There are more references available in the full text version of this article.

Cited by (42)

Agitation: measurement, management, and intervention research
1995, Archives of Psychiatric Nursing
Strategies for controlling and managing agitation of patients in long-term care populations has been identified as a research priority. Unfortunately, there is a paucity of literature on empirically tested therapeutic interventions for agitation. This manuscript summarizes the literature related to the measurement, management, and interventions for agitation and identifies a nursing research agenda for conducting research in this area. Nonpharmacological and nonrestraint interventions are highlighted and categorized by (1) alterations in care given, (2) environmental adaptations, and (3) behavioral approaches. Future research areas identified by the authors focus on additional types of environmental, interpersonal, and behavioral interventions as well as theoretical predictors of agitation; the influence and role of nursing personnel and caregiver; and the legal and ethical issues involved in caring for patients who manifest agitation.
Control and dependency in residential care settings for the elderly: Perspectives on intervention
1988, Advances in Psychology
Residency for the elderly in a long-term care institution has been described as fostering a diminished sense of personal control and increased dependency behavior and helplessness. The development of dependency and the decline of personal control has also been associated with poorer psychological adjustment and physical health. This chapter examines the relationships among social cognition and operant learning approaches to dependency behavior and personal control in the context of long-term residential care settings. Principal behavior domains of residents which are at risk for diminished personal control are described with special attention to the regulation of social interaction, privacy, and self-care activities. A review of the existing research on planned interventions to enhance personal control and independent behavior of elderly residents in residential care is presented with a critical examination of the validity of the findings and their implications for the management of residential care settings. The characteristics of elderly residents and the properties of care settings which influence personal control and dependency behavior of residents are discussed to identify potential entry points for intervention activities. Particular emphasis is given to caregiver/recipient interaction as a potential therapeutic modality. The chapter concludes with considerations for developing control enhancing interventions and more effective experimental evaluation of approaches to intervention.
Vocally disruptive behaviors management in older people with dementia
2017, Geriatrie et Psychologie Neuropsychiatrie du Vieillissement
Introduction to clinical psychology: Science, practice, and ethics
2015, Introduction to Clinical Psychology: Science, Practice, and Ethics
"just make it stop": A case report of excessive crying in an individual with dementia
2013, Journal of the American Geriatrics Society
Older adultgs acceptability ratings of treatments for verbal agitation in persons with dementia
2010, American Journal of Alzheimer's Disease and other Dementias

View all citing articles on Scopus

^∗: Sharon Lascomb is a student of nursing in the College of Human Development, The Pennsylvania State University, Pennsylvania, U.S.A.

View full text

Article preview

International Journal of Nursing Studies

Abstract

References (17)

Behavior modification: Principles and Clinical Applications

The psychiatric nurse as a behavioral engineer

J. exp. Anal. Behav.

Health care from a behavioral-ecological viewpoint

Growing Old

Recreation participation patterns of successful aging

J. Gerontol.

Milieu treatment of the aged in institutions

Gerontologist

A token economy program on a mixed chronic and geriatric ward

Application of operant techniques to the modification of elderly behavior

Gerontologist

Cited by (42)

Agitation: measurement, management, and intervention research

Control and dependency in residential care settings for the elderly: Perspectives on intervention

Vocally disruptive behaviors management in older people with dementia

Introduction to clinical psychology: Science, practice, and ethics

"just make it stop": A case report of excessive crying in an individual with dementia

Older adultgs acceptability ratings of treatments for verbal agitation in persons with dementia