Functional behaviour analysis guided interventions might improve transfer-related behaviour in dementia care dyads: a single case study

Abstract

Background: Impaired mobility in people with severe dementia is well known. Physical therapists play a key role in guiding professional caregivers on how to handle mobility and transfer-related problems; however, it is unknown how to handle the complexity of dementia-related impaired endurance, joint dysfunction, balance, and gait dysfunction and at the same time, take into consideration the person's decreased cognition, communication deficits, and behaviour problems. Aims and methods: The aim was to explore the effectiveness and efficiency of functional behaviour analysis (FBA) guided interventions of dyadic transfer-related behaviour in dementia care dyads. An experimental single-case research design was used. Two care dyads participated. Different methods of assessment were performed to gather the dyadic transfer-related behavioural problems. Transfers were recorded by video uptakes and to generate a hypothesis about dyadic transfer-related behavioural problems, the Dyadic Interaction in Dementia Transfer Assessment Scale (DIDTAS) was used. Results: The problematic transfer-related behaviour in care dyad 1 changed positively, as reflected by a decrease in discomfort verbally expressed by the person with dementia. A trend towards increased cooperation was observed among caregivers assisting in the transfer situation. In care dyad 2, a trend towards increased caregiver self-efficacy (SE) was observed between the baseline and completed intervention phases. The decreased resistiveness to care (RTC) exhibited by the person with dementia paralleled the increase in caregiver SE. Conclusion: Considering the findings of this explorative study, physical therapists could consider the development of tailored interventions guided by an FBA for complex dyadic transfer-related behavioural problems in dementia care dyads.