HOW IS A BEHAVIORAL
ASSESSMENT
CONDUCTED?
American Psychological Association
Table of Contents
Why Practitioners Need Information
Behavior disorders are frequent precipitants for admission to a psychogeriatric
inpatient unit and may cause significant difficulties for family members
or staff in acute medical units and nursing homes. Behavior disorders can
take the form of physical aggression, motor overactivity (e.g., wandering),
and disruptive vocalizations. Common causes of behavior disorders are delirium,
dementia, depression, psychosis, and premorbid personality traits. Interpersonal
and environmental factors may be antecedent to behavioral episodes, and
an assessment of these is central to developing a treatment plan. While
outwardly expressed behavioral problems are easily identifiable, behavior
deficits (e.g., social withdrawal) can be more easily overlooked.
- Agitation may be the result of an underlying physical condition, and referral for a medical workup may be needed.
- Agitation in older adults is often attributable to chronic cognitive impairment and/or overstimulation in the environment. Changes in the milieu and in the response of staff, family, or other caregivers may reduce disruptive behavior.
- Treatment plans that are supported by detailed behavioral analyses may increase staff receptivity to necessary systemic change. For example, careful observation may determine that the wandering problem of a nursing home resident can be reduced if the administrator of the institution designates a safe place for ambulation.
- In institutions or residences, agitation may only occur at certain times of the day or evening, or only with particular caregivers, or only during specific activities (e.g., feeding, bathing). In such cases, the possibility of modifying existing caregiver behavior or routines should be assessed.
- Family members may more closely attend to the older adult when he or she becomes agitated. Evaluation of family members' ability or motivation to change their own behavior should be conducted.
- Positive reinforcement of appropriate behavior in the agitated individual may increase its occurrence and reduce disruptive behavior.
