Nonpharmacological Management of Behavioral Problems in Persons with Dementia: The TREA Model

Alzheimer's care today 12/1999; 1(4).

ABSTRACT : Several subtypes of problem behaviors are related differentially to personal and environmental characteristics. These subtypes are useful in guiding the formulation of an individualized treatment plan. This article presents the TREA-Treatment Routes for Exploring Agitation-approach for individualizing treatment plans for behavioral problems. Such a plan involves several stages: (a) hypothesize which need underlies the agitated behaviors; (b) characterize the way in which the behavior results from the need (eg, Does the behavioral attempt to accommodate the need? Does it express discomfort? Does it attempt to communicate the need?); and (c) provide an intervention that either provides for the unmet need, or, alternatively, when the behavior itself is alleviating the need, provide a method in which the behavior can be accommodated, When an intervention to provide for the unmet need is required, it needs to be matched to the person's sensory, mental, and physical abilities, as well as to the person's habits and preferences. The goal of the plan is to improve the quality of life for the patient, and to reduce the burden on caregivers. Case examples illustrate this approach.
(C)2000Aspen Publishers, Inc.

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