The Use of Problem-Solving Therapy and Restraint-Free Environment for the Management of Depression and Agitation in Long-Term Care

Abstract

We demonstrate the use of behavioral techniques with older adults in long-term care settings, using two case examples. Ms. N is an 81-year-old woman with mild cognitive impairment who attended 12 sessions of problem-solving therapy for ongoing depression. Her Montgomery Asberg Depression Rating Scale score of 30 (moderate levels of depression) decreased to 6 (not depressed) following treatment. Mr. K is a 77-year-old male with moderate to severe Alzheimer's disease who was referred for treatment of behavioral problems. Following 10 weeks of restraint free environment, his Cohen Mansfield Agitation Inventory score declined from 60 (moderate behavioral problems) to 38 (minimal problem behaviors), indicating a significant reduction in agitation. Through these two cases, we provide a description of behavioral interventions for the treatment of depression and behavioral problems in long-term care settings.

KEYWORDS:

• long-term care
• agitation
• depression
• behavioral interventions
• dissemination
• problem solving therapy
• restraint free environment

Acknowledgments

This study was supported by a grant of the Substance Abuse and Mental Health Services Administration, Grant number 4 H79 SM52236-03-1 provided to Patricia A. Areán, PhD.

Notes

Agency for Healthcare Research and Quality. (2004). Pharmacological treatment of dementia. (AHCPR Publication No. 04-E018-2). Rockville, MD: Agency for Healthcare Research and Quality (AHRQ).