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S70
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
Results:
STC identified for these behavioral categories are theories
on regulation of emotions. Behavioral categories emanating from
this construct are; Emotional Behaviors (EB), Fretful/Trepidated
Behaviors (FTB) and Vocal Behaviors (VB).
Conclusions:
EB are based in expression of the emotion of
melancholy and discontentment. EB based in melancholy provide
the patient with a measured catharsis to allow for decompression
from pain. EB based in discontentment provide the patient with
protection from pain. FTB are based in the expression of emotion
of fear. FTB make caregivers aware of the insecurity needs of the
patient. VB are based in the expression of emotions of anger and
joy. They highlight the ‘out of proportion’ nature of responses
in patients. This response may or may not be associated with
functional motor activity (FMA).
P-143
Classification of behaviors in dementia based in “motivational”
and “needs based” theories
A.S. Luthra
Program for Older Adults, Homewood Health Centre, Guelph, Canada
Objective:
There is vast heterogeneity in use of terminology and
classification of behaviors in dementia with no universally accepted
classification system. The objective is to classify behaviors in
dementia based on impairment in “motivational” and “needs based”
theories.
Methods:
Criteria proposed by Davis, Buckwalter and Burgio
(1997) were identified as the basis for classification of behaviors
in dementia. A review of literature was done with a view
to identify the “Specification of the Theoretical Construct” to
justify aggregation of similar behavioral symptoms into clinically
meaningful categories.
Results:
“Specification of the Theoretical Construct” identified for
these behavioral categories are motivational and needs based
theories. Behavioral categories emanating from these constructs
are: Apathy Behaviors (AB), Goal Directed Behaviors (GDB), Motor
Behaviors (MB), and Importuning Behaviors (IB).
Conclusions:
Apathy behaviors are the result of a decrease in the
motivational drives with an absence of any need fulfillment. Goal-
Directed Behaviors are the result of an increase in motivational
drives with increase in detection and fulfillment of “belongingness”
needs. Motor behaviors are the result of varying degrees of changes
in motivational drives and are concomitants to other behavioral
categories. Importuning behaviors are the result of preserved
motivational drives in detection and fulfillment of “physiological
needs”.
P-144
Classification of behaviors in dementia based on theories of
information processing
A.S. Luthra
Program for Older Adults, Homewood Health Centre, Guelph, Canada
Objective:
There is vast heterogeneity in use of terminology
and classification of behaviors in dementia with no universally
accepted classification system. The objective is to classify behaviors
in dementia based on impairment in theories of information
processing.
Methods:
Criteria proposed by Davis, Buckwalter and Burgio
(1997) were identified as the basis for classification of behaviors
in dementia. A review of the literature was done to identify
the “Specification of the Theoretical Construct” (STC) to justify
aggregation of similar behavioral symptoms into clinically
meaningful categories.
Results:
STC identified for these behavioral categories are those
based in theories on information processing (TIP). Two behavioral
categories emanating from pathological changes in TIP are:
Disorganized Behaviors (DOB), and Misidentification Behaviors
(MiB).
Conclusions:
DOB is the result of an alteration in the physiological
status of the patient. This result in changes in arousal and
attentiveness and this, in turn, leads to impairment of the sequential
organization of information processing thereby giving way to
fragmentation of the process at many different levels of the brain.
MiB are the result of a specific breakdown in two specific steps of
TIP; schema identification and pattern recognition. This result in
the failure of the usual pairing of old and new information with
an altered sense of relatedness between self and persons, places,
objects and events.
P-145
Reliability and validity of LuBAIR scale to measure behavioral
and psychological symptoms in dementia (BPSD)
A.S. Luthra
Program for Older Adults, Homewood Health Centre, Guelph, Canada
Objective:
Establish the reliability and validity of Luthra’s
Behavioral Assessment and Intervention Response (LuBAIR) Scale.
It is hypothesized LuBAIR Scale will be less labour intensive, more
comprehensive and offer improved categorization of behaviors into
clinically meaningful categories.
Methods:
120 residents with a dementia diagnosis from seven long
term care facilities were recruited for the study. Sixty residents
exhibiting BPSDs were included in the study group and sixty
participants not displaying BPSDs were in the control group.
Pittsburg Agitation Scale was used to screen for presence of BPSDs.
Two registered nurses (RN) completed LuBAIR, BEHAVE-AD, and
Cohen-Mansfield Agitation Inventory (CMAI) for each participant
in the study group. This was done to establish inter-rater, Construct
and Criteria Validity. Fourteen days later, the same RN completed
LuBAIR Scale again for each participant for intra-rater reliability. A
Clinical Utility Survey (CUS) was developed to evaluate the nurses’
viewpoints on the usefulness of LuBAIR Scale on three variables:
less labor intensive, more comprehensive and better categorization
of behaviors in clinical meaningful categories.
Results:
Intra-rater reliability was established for 8 of 12 and inter-
rater reliability for 10 of 12 behavioral categories. LuBAIR Scale had
comparable Construct and Criteria Validity. CUS findings showed
23% of nurses found LuBAIR less labor intensive, 77% found it more
comprehensive and 98% agreed LuBAIR helps understand behaviors
in clinically meaningful ways.
Conclusions:
LuBAIR Scale has acceptable inter- and intra-
rater reliability and Construct and Criteria Validity. It is more
comprehensive and is better able to categorize behaviors in
clinically meaningful categories.
P-146
Results of geriatric cardiac surgery co-management of older
patients with valvular heart disease
E. Ortolani
1
, N. Pavone
1
, S. Forcina
1
, M. Massetti
1
, R. Bernabei
2
,
E. Marzetti
1
1
Catholic University of the Sacred Heart, Rome, Italy;
2
Italy
Objectives:
The growing burden of valvular heart disease (VHD)
in older populations demands a substantial change of the
current management of this condition. The present work reports
preliminary results of a multidisciplinary approach for the care of
older patients with VHD.
Methods:
Data are from an ongoing prospective study analysing
clinical outcomes of older VHD patients admitted to the Heart
Valve Clinic (HVC) of our Centre. All patients underwent
multidisciplinary evaluation including echocardiography, cardiac
surgeon consultation, multidimensional geriatric assessment, and
neuropsychological testing. Other consultations were performed as
needed. Demographic characteristics and clinical outcomes of older