Showing papers by "Tamar Heller published in 1996"

Practice guidelines for the clinical assessment and care management of Alzheimer's disease and other dementias among adults with intellectual disability. AAMR-IASSID Workgroup on Practice Guidelines for Care Management of Alzheimer's Disease among Adults with Intellectual Disability.

Abstract: The AAMR/IASSID practice guidelines, developed by an international workgroup, provide guidance for stage-related care management of Alzheimer's disease, and suggestions for the training and education of carers, peers, clinicians and programme staff. The guidelines suggest a three-step intervention activity process, that includes: (1) recognizing changes; (2) conducting assessments and evaluations; and (3) instituting medical and care management. They also provide guidance for public policies that reflect a commitment for aggressive care of people with Alzheimers's disease and intellectual disability, and avoidance of institutionalization solely because of a diagnosis of dementia.

Practice guidelines for the clinical assessment and care management of Alzheimer's disease and other dementias among adults with intellectual disability*

Abstract: The AAMR/IASSID practice guidelines, developed by an international workgroup, provide guidance for stage-related care management of Alzheimer's disease, and suggestions for the training and education of carers, peers, clinicians and programme staff. The guidelines suggest a three-step intervention activity process, that includes : (1) recognizing changes ; (2) conducting assessments and evaluations ; and (3) instituting medical and care management. They also provide guidance for public policies that reflect a commitment for aggressive care of people with Alzheimers's disease and intellectual disability, and avoidance of institutionalization solely because of a diagnosis of dementia.

Impact of person-centered later life planning training program for older adults with mental retardation

Abstract: This study examines the effectiveness of a person-centered later life planning training program for older adults with mental retardation, their family, and staff. It is conceptually based on two complementary orientations: a lifespan development orientation (Baltes & Danish, 1980) and an ecological perspective on empowerment (Rappaport, 1987). Modern gerontological theory draws from the literature in lifespan development which emphasizes the possibilities of modification and/or change in all age groups. The premise is that behavior change can occur at any point in the life cycle. Rappaport (1987) has defined empowerment as a "belief in the power of people to be both the masters of their own fate and involved in the life of their several communities." Empowerment strategies include both a focus on help-seeker's behaviors and skills, and help-givers' roles in helping relationships (Dunst, Trivette & Deal, 1988). To increase empowerment, the help-seeker or learner needs to develop: 1) access and control over needed resources; 2) decision-making and problem-solving abilities; and, 3) instrumental behaviors needed to interact effectively with others to procure resources. A broader ecological approach to empowerment also assumes that: 1) people are competent or have the capacity to become competent; 2) poor functioning is due to failure of the social system to create opportunities for competency to be displayed; and, 3) when new competencies need to be learned, the learner must attribute behavior change to his or her own actions if one is to acquire a sense of control and self-efficacy. This empowerment model suggests that interventions be designed to mobilize resources on behalf of individuals and to empower individuals to deal more effectively with their environment. A major consequence is increased well-being and enhancement of problem solving abilities. Assuming responsibility for solutions to problems has consistently been related to positive affect and enhanced well being. Also, research has indicated that people who report a greater sense of self-efficacy in producing behavior change are more likely to maintain those behaviors and display positive responses (Brickman et al., 1982). Hence, the training intervention in later life planning aims to increase empowerment of older persons with mental retardation by: 1) enhancing their abilities to make decisions through provision of information, skill training, and opportunities to experience new options and make informed choices, and 2) training help-givers (professionals, families) to better assist individuals in identifying what is important to them, to provide opportunities for people to make choices, and to support people in the choices they make while helping them understand the meaning and potential outcomes of their choices. In discussing expected outcomes of empowerment in the planning process for people with developmental disabilities, Mount and Zwernik (1988) note that the "focus is on opportunities for people with disabilities to develop relationships, have positive roles in community life, increase control of their own lives, and develop the skills and abilities to achieve these goals." In American society today, there is a general consensus that people are entitled to new choices and experiences at the end of their working years. More recent trends suggest that part-time work, phase down, full-time retirement and second careers or new and different work and leisure experiences are all viable options (Dykwald, 1990). Individual as well as work-related factors influence the retirement decision (Atchley 1990; Stems, Matheson & Schwartz, 1990). Among these are health, income, a positive attitude, and pre-planning. Stems et al. 1990) found that the planning factor is highly significant, leading to higher satisfaction and better adjustment to the retirement process. Having a voice in the decision and plan also has been identified as significant, generally correlating with higher life satisfaction and better health (Kimmel, Price & Walker, 1978). …