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Ann Longterm Care. 2008 Nov;16(11):17-21.

The Effectiveness of an Environmental and Behavioral Approach to Treat Behavior Problems in a Patient with Dementia with Lewy Bodies: A Case Study.

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Dr. Huh is Associate Director for Education and Evaluation at the VA Palo Alto Health Care System Geriatric Research, Education, and Clinical Center; Dr. Areán is Associate Professor, Dr. Bornfeld is Staff Psychologist, and Dr. Elite-Marcandonatou is Staff Therapist at the Department of Psychiatry, University of California, San Francisco.


This case describes and reports the effects of a multi-component collaborative intervention to treat difficult behaviors in a 79-year-old woman with dementia with Lewy bodies (DLB). To assess for cognitive status and disruptive behavior patterns, we collected a cognitive screen, history of presenting illness, and measures of behavior problems prior to the intervention. The intervention included 32 weekly 1-hour sessions with the patient, 1-hour sessions with the patient's assigned caregiver and regular interactions with the patient's family and medical treatment team. All sessions were conducted at the patient's long-term residential care facility. We assessed behavior disturbances with the Cohen-Mansfield Agitation Inventory (CMAI). We assessed functional abilities with the Katz Activities of Daily Living (K-ADL), and assessed cognitive function with the Mini-Mental Status Exam (MMSE). At the closing session (week 32) caregiver ratings indicated significantly reduced scores on the CMAI (Baseline = 75 to Endpoint = 30) and maintenance in ADLs (Baseline=3 to Endpoint=3). Caregivers reported enhanced efficacy in treating behaviors and improvement in their relationship with the patient. Results demonstrate the benefits of a multi-component collaborative intervention, based on an enhanced environment and behavioral approach, in treating behavior problems related to DLB.


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