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August 14-16, 2017 | Toronto, Canada
BRAIN DISORDERS AND DEMENTIA CARE
4
th
International Conference on
Neurosurg, an open access journal
ISSN: 2471-9633
Proposed new classification of behaviors in dementia
Atul Sunny Luthra
Homewood Health Centre, Canada
Objectives:
Currently,thereisavastheterogeneityinterminology
and classification of behaviors used in dementia care, with no
universally accepted classification system. This presentation will
establish and discuss in detail clinically meaningful categories
for the classification of behaviors, using a new behavioral scale
called LuBAIR (Luthra’s Behavioral Assessment and Intervention
Response.) It is intended for audiences of all disciplines and
backgrounds in geriatric psychiatry and dementia/NCD.
Methods:
Criteria proposed by Davis, Buckwalter and Burgio
(1997) were identified as the basis for classification of behaviors
in dementia. A review of the literature was done to identify
the “Specification of the Theoretical Construct” (STC) to justify
aggregation of similar behavioral symptoms into clinically
meaningful categories.
Results:
STC identified are divided into four behavioral
constructs used to categorize behaviors in dementia: Theories
of information processing, theories based in motivation
and needs, theories based in the regulation of emotions,
and theories based in compliance and aggression. Each
construct is subdivided into different categories: Theories of
information processing (TIP): disorganized behaviors (DOB)
and misidentification behaviors (MiB); motivational and needs-
based theories: apathy behaviors (AB), goal-directed behaviors
(GDB), motor behaviors (MB), and importuning behaviors (IB);
theories on the regulation of emotions: emotional behaviors
(EB), fretful/trepidated behaviors (FTB), and vocal behaviors
(VB); theories on compliance and aggression: oppositional
behaviors (OB), and physically aggressive behaviors (PAB).
Discussion:
The STC identified for these behavioral constructs
result from alterations of the physiological and emotional
statuses of patients with dementia. Physiologically, DOB and
MiB occur due to fragmentation of information processing and,
for MiB specifically, the breakdown of schema identification and
pattern recognition. Motivational and needs-based behaviors
stem from changes in motivational drives; while GDB and IB
result from an increase in motivational drive in detection and
fulfillness of needs of “belongingness” and physiological needs
(respectively). Motor behaviors (MB) are due to varying degrees
of changes in motivational drives, and are concomitants to
other behavioral categories. EB and FTB are based in the
expression of negative emotions; feelings of melancholy
and discontentment give rise to EB to allow for catharsis
and subsequent decompression from pain, and FTB express
emotions of fear, illustrating insecurity needs to caregivers. VB
can be based in both emotions of joy or anger, and highlight
the “out of proportion” nature of patient responses. Finally,
oppositional behaviors (OB) are determined by the degree of
cognitive impairment of patients with dementia, and result
from non-compliance with direction, where PAB occur due to a
patient’s perceived impediment in goal attainment.
e:
SLuthra@homewoodhealth.comNeurosurg 2017, 2:2
DOI: 10.21767/2471-9633-C1-006