ButterflyEffects.com

Problematic behavior is the primary challenge that keeps aging individuals from living with as much independence and enrichment as their physical health allows.

At Butterfly Effects, we believe that every person deserves every opportunity to live with as much independence as possible. All of us greatly benefit, the more we can include seniors as active members of our families and communities.

You don't need to wait for quirky behaviors to become dangerous.
Whether your beloved family member is living at home or in nursing facility, we can employ Applied Behavior Analysis (ABA) to affect immediate and lasting change. Through direct one-on-one interventions, we can work with you and your loved one to compensate for cognitive challenges so as to:

• Overcome eating issues including food refusal
• Promote improved hygiene
• Facilitate independent grooming and dressing
• Counter dangerous behaviors such as wandering and errant driving
• Curb repetitive vocalizations
• Encourage medical compliance
• Deter aggressive behaviors

More research needs to be done, but what has been done indicates that behavioral problems are especially significant among geriatric populations living in skilled nursing facilities. This supports the commonly believed premise that poor behavior is the precipitating factor leading to most institutionalizations. (Dwyer-Moore and Dixon, 2007) Risky, aggressive, reclusive, and neglectful behaviors are typical problems associated with Alzheimer's and other forms of senility.

At Butterfly Effects, we're helping to change how society approaches behavioral issues with seniors.
In addition to current research, our own experience using behavioral interventions with adult populations supports a proactive strategy. We've experienced success in working with seniors in skilled nursing environments, as well as those adults living semi-independent lives within their families.

More and more evidence is supporting the effectiveness of applying Functional Behavioral Assessments followed up by therapies based on Applied Behavior Analysis (ABA). (Baker et al, 2006)

Behaviors are seldom random.
Instead of looking at behaviors, especially those associated with Alzheimer's, as random, we understand that they are functional in that they serve a purpose, involve recognizable patterns, and are often triggered by identifiable antecedents.

Most importantly, it means that a problematic behavior can be replaced with a more appropriate one if it better serves the individual's intended function. Typically, those functions are designed to gain attention, escape or counter an unpleasant task or situation, gain access to a desired object or activity, or relieve perceived bodily discomfort.

At Butterfly Effects, we work with adults who are living at home as well as institutional care settings, and in both settings have achieved significant modification of dangerous and disruptive behaviors through the use ABA-based therapy.

Drugs aren't the only choice.
Medication continues to be the primary therapy for  individuals exhibiting behavioral issues. A 2010 study demonstrated that nearly two-thirds of seniors living in skilled nursing settings are receiving psychotropic medications. (Bhattacharjee et al, 2010). Another study indicated the prevalence rate to be anywhere from 50 to 80 percent across the world. (Mann et al, 2009) But as we have learned over the years in treating individuals with developmental disabilities and Autism, medication is rarely a complete answer, and in many cases is an inferior solution caompared  to behavioral therapy.

Serving the needs of individuals with Alzheimer's and other adults exhibiting behavioral challenges, the Butterfly Effects team will:

• Record detailed input from relatives and caregivers regarding the targeted behavior, including antecedents and consequences
• Provide full evaluations performed by board certified and licensed clinicians experienced in working with seniors
• Track and assess the problem behavior to determine its perceived function
• Develop a treatment plan
• Apply the treatment plan, working one-on-one with the individual in a restricted environment to teach a new behavior to replace the problematic one
• Generalize those skills from restricted to community settings

At Butterfly Effects, we will also:

• Provide case management support linking services and organizations, as well assisting with paperwork and facilitating insurance benefits
• Train caregivers in the principles and teaching techniques associated with ABA
• Involve other professionals as needed for services and therapies including occupational, physical, and speech therapy.

Butterfly Effects also provides consultative and training services to skilled nursing and other care facilities. We will come to your organization to:

• Train your staff how to assess behavioral function, create a treatment plan, and implement it using one-on-one teaching strategies based on ABA principles
• Provide group and individual supervision services for staff
• Perform assessments, develop treatment plans, and implement them with individual clients
• Perform consultation and oversight regarding the set-up of an ABA-based program, including assessment procedures, data collection and analysis, and review of results

Federal regulations currently state that behavioral interventions be attempted before any chemical restraints are prescribed.
Hopefully, Butterfly Effects can help lead the way in modifying these regulations to match those now in place in public education, so that functional assessments and ABA-based therapies are required as first lines of treatment.

At Butterfly Effects, we believe that everyone deserves every opportunity to live with as much independence as possible, with access to enriching activities. We want to team with your family to make sure that happens.

Don't wait for minor inconveniences to grow into major problems. 
Whether your beloved family member is living at home or in a care facility, call Butterfly Effects today, to see how we can help.


Read about Butterfly Effects commitment to help reinvent adult and senior care.

Read more about the research on using behavioral approaches
as the first line of intervention with adults and seniors.

Read about support for family caregivers.

References:

Baker, JC, Hanley, GP, and Mathews, RM, 2006. "Staff-Administered Functional Analysis and Treatment of Aggression by an Elder with Dementia." Journal of Applied Behavioral Analysis 2006 Winter; 39(4): 469-474. doi:  10.1901/jaba.2006.80-05

Bhattacharjee S, Karkare SU, Kamble P, Aparasu RR, 2010. "Datapoints: Psychotropic Drug Utilization Among Elderly Nursing Home Residents in the United States." Psychiatric Services 2010; 61:655-655. Retrieved from
http://psychiatryonline.org/article.aspx?articleid=101462

Dwyer-Moore, KJ and Dixon, MR, 2007. "Functional Analysis and Treatment of Problem Behavior of Elderly Adults in Long-Term Care. Journal Of Applied Behavior Analysis 2007, 40, 679-683

Mann E, Köpke S, Haastert B, Pitkälä K, and Meyer G, 2009. "Psychotropic medication use among nursing home residents in Austria: a cross-sectional study." BMC Geriatrics 2009, 9:18 doi:10.1186/1471-2318-9-18
Retrieved from http://www.biomedcentral.com/1471-2318/9/18