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Of the many barriers of utilizing behavior analytic principles within the elderly community, I believe the lack of services available would be the biggest problem. Even if caregivers are provided adequate training in ABA, I still think there would be a great need for ABA services because of the increase in persons entering the elderly community. Hopefully people will be more reliant on behavioral services and less on pharmaceuticals, but by the time the baby boomer generation are in need of such services, there will be a great need for caregivers, in general.

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One of the barriers to utilizing behavior analysis in elderly patients is ethical concerns. I think as some adults become older and begin to lose cognitive abilities/functioning, it becomes increasingly difficult to respect and maintain their autonomy, while also providing adequate care for them. I have witnessed this first hand with my own grandparents, and can attest that it is incredibly difficult for the families and caregivers. One way we can overcome this barrier is by creating and implementing objective, formalized assessments to help decipher whether individuals are cognitively able to make decisions in their best interests. Additionally, we should always consult with our clients and their caregivers when devising and implementing behavioral interventions.

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Very nice presentation Jenna! I would say that a large barrier for ABA not being implemented within the elderly community would be the high turn over within the elderly care profession causing a lack of consistency with implementation and data collection. One way that we can overcome this is to make sure that each new employee is trained appropriately and ongoing observation and feedback is done within the facility. This will allow for individualized feedback for each employee and ensure that treatment is being implemented with fidelity.

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From the presentation and my personal experiences involving elderly care, I feel that the greatest barrier is the focus on the medical model. It is understandable that with progressive health problems as one gets older, that this would be the main concern. As one’s health is deteriorating caregivers may also be too emotionally and physically drained to try an alternative approach to intervene.  I think the first step in overcoming this is to first and foremost explain that the medical model and the behavioral model are not mutually exclusive. Caregivers do not need to abandon one way to may room for another intervention. Understanding that both models can be used together may open people’s minds to trying another approach.

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Hey Jenna, Great presentation!
You talked about three areas where there are barriers for behavior analysts including data collection, data analysis, and ethical concerns . I believe that one of the biggest barriers is data collection. Data collection is vital because without strong data we cannot be sure of the baseline or the results of interventions. One major way to overcome this is to work with lawmakers to establish laws on data collection for elderly individuals. Another way to try and "fix" this issue would be to practice consistency when the data is collected, this includes using operationally defined behaviors and reliable data collection methods.

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One of the greatest barriers to utilizing behavior analytic principles with the elderly is the lack of mandated federal laws established in the United States in regard to data collection. The regulations that do exist vary by state making it difficult to ensure the integrity of programs and/or that data is recorded accurately and consistently. In order to overcome this barrier federal regulations can be established to ensure fidelity of the treatment everywhere.

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Based on the presentation one of the barriers that elderly community struggle with is consist with services. As an adult so many providers are involved in the life and sometimes it becomes difficult for all providers to be on the same page. The lack of resources can be difficult to find the right provider and someone who is willing to put in the work. I have noticed in my personal experience that people will open an agency to help those with a disability but don’t have a background in behavioral skills, or don’t have experience working with elderly.

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It seems that the greatest barriers in the elderly community is with caregivers. The caregivers often have no behavior analytic background and may be unwilling to follow the plans. To overcome this barrier it is important t educate the caregiver in behavior analysis and provide enough support to them to follow through as well as provide the caregivers proper reinforcement for following through with the plan. aside from lack of knowledge, it is sometimes easier for the caregivers to do things for the elderly then follow through on plans that give them independence.

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I think that the greatest barrier to utilizing behavior analytic principles within the elderly community would be data analysis. If practitioners do not have control over the environment there could potentially be other variables that influence the implementation of treatment plans and practitioners would have to be very careful and fully aware of those variables. For example, if an elderly person started to take a new type of mediation that has side effects, such as causing drowsiness or headaches, the behavior analyst would have to keep record of what changes were made and what type of influence it may have on the treatment plan. To overcome this barrier and promote the use of behavior interventions everyone who is working with the elderly person would have to effectively communicate with each other. Any changes made that could affect the treatment plan should be shared and everyone involved with the elderly person should work as a team.

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Barriers to utilizing behavior analytic principles within the elderly community include, lack of acceptance, funding, and knowledge. Many people do not know the positive effects that behavior analysis can have on the elderly population, so they do not accept it as a treatment. To overcome this barrier, it is important to disseminate information about behavior analysis to providers of elderly individuals that could benefit from behavior analysis services. It is also important to inform the family of elderly individuals who could benefit from behavior analytic services in order to have advocates for these individuals.

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I believe that one of the greatest barriers to utilizing behavior analytic principles within the elderly community is the inconsistency/discrepancies between reporters. Because these individuals are often being cared for by their children, nurses, or in a nursing home, there may be a variety of people involved in their care. This can make it more difficult to ensure that consistent intervention and data collection procedures are being implemented effectively across all potential caregivers. I think that we could work towards overcoming this barrier through education of those that are taking on the caregiver roles. By focusing on meeting with and training those that will take the role of caregivers for the individual, we can better ensure that we are on the same page with implementing interventions, and taking appropriate data. It would be important to meet regularly with these individuals, to ensure that they remain consistent and understanding of the interventions, as well as to ensure any new caregivers will have the opportunity to receive the necessary training. This training could include ensuring the caregivers fully understanding the operational definitions that are being used, as well as the interventions being used. This would also include training and modeling the actual interventions, and having the caregivers display knowledge of these procedures through role play and through implementing them with the specified client, while under observation of the BCBA. Just as we stress the importance of caregiver/parent training when working with children with disabilities, it is important to ensure the full training of caregivers of this population.

Thanks so much!

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Based on the presentation and from my own personal experience, I think the greatest barriers involved in implementing behavioral analytic treatment are when ethical considerations arise due to the clients current cognitive functioning. When dealing with the elderly, especially in long-term-care facilities there is a high chance in dealing with client’s that have dementia, Alzheimer’s, and other comorbid conditions.  Therefore, it may be difficult to determine at what stage and degree, such conditions and/or other ailments may limit the clients ability to consent or make sound decisions about the treatment and the overall well being of their health. As a result it's imperative to have the client's current cognitive functioning to asses, whether the client can legally consent to treatment. If the current illness is enough to impair judgment, than it's imperative to find out if the client has  MPOA (Medical Power of Attorney). Based on the chapter, A Medical Power of Attorney, is an agent the client trusts to make legal medical decision on his/her behalf. If there is evidence of cognitive impairment the MPOA would allow us to implement behavioral analytic treatment to improve the clients well-being.

Excellent presentation Jenna!

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From the presentation, it seems as if getting caregivers on board with behavioral interventions could be a large barrier. Caregivers who are more focused on the medical model may think that that is the most effective intervention and may not be open to a behavioral intervention which they have never heard of. Caregivers may also be reluctant to learn a new way of doing things, especially those caregivers working in settings such as residential care facilities. They already have a lot on their plate, and may not be open to learning a new way of doing things.

To overcome this barrier, it is important to inform caregivers of what behavior analysis is and how it could help make both the patient's and their own lives easier. Getting the caregivers on board is the first step, but the second step would be training them on how to implement the interventions and ensure that they are following them with fidelity in order to see the best results. Providing caregivers with ample support and making the interventions simple and fairly easy to implement would be some of the first steps to promote the use of behavioral interventions with this population.

Great presentation Jenna

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5- Replies to the discussion prompt in full, answering all parts of the question. The response is on topic and relevant to the field of behavioral geronology.

2.5 – Replies partially to the discussion prompt, omitting responses to 1 of the two questions.

0- no response or response is not related to the topic.

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Based upon your own knowledge and experience or using the information from the presentation, in your opinion what is the greatest barrier to utilizing behavior analytic principles within the elderly community? What can be done to overcome this barrier and to promote the use of behavioral interventions with this population? Initial Response due Thursday 2/21/19 @ 11:55 PM