Model of Psychological Intervention in Dementia Care
Polly Shepard, Psy.D. Corby Bubp, Ph.D.Clinical Neuropsychology/Psychology
LearningDisability
Assessment
IndividualTherapy
CareerCounseling
CustodyEvaluation
CompetencyEvaluation
ParentCoordination
BiofeedbackTherapy
Neuropsychological Assessment
Marital/FamilyTherapy
PsychiatricAssessment
PPS
The Memory Clinic of IndianapolisProvide compensatory strategies and
recommendations for home and schoolIdentify potential barriers for decision
making in daily living (e.g. independent living, driving, financial decision making, etc.)
Provide assessment, consultation, and testimony for issues related to competency and brain-related impairments.
The Memory Clinic of Indianapolis
Pediatric and Adult Neuropsychological EvaluationsPsychoeducational EvaluationsTo determine Learning Disorders and AD/HD
Evaluate cognitive strengths and weaknesses in chronic medical diagnosesPre-and post-concussion/TBI evaluationsSchool readiness/private school admission evaluationsDistinguish neurological vs. emotional/psychiatric syndromes
What is a Neuropsychologist?Neuropsychology =
study of brain-behavior relationshipsEducational requirements
1. Ph.D./Psy.D. in Psychology with emphasis in neuropsychology
2. Doctoral level internship with 50% devotion to neuropsychology
3. 2 year fellowship/residency in neuropsychology
4. Board certification in Clinical Neuropsychology by the American Board of Professional Psychology (ABPP)
Referral Triggers1. Prior Psych Diagnosis2. Psychotropic/Sedative
use3. Behavioral Issues4. MDS Trigger5. Staff-patient interaction6. Non-compliance with
Treatment7. Substance/Medication
abuse8. Cognitive/Behavioral
change
Treatment and InterventionsBehavioral-based Interventions
WanderingSleep managementHallucinationsPhysical/Verbal abusive behaviors
DiagnosticsScreen/Full Neuropsych AssessmentTesting instruments designed to evaluate:
Cognitive (IQ, Memory, Attention, Problem Solving, Insight, Executive Functioning, Language, Motor Skills, Judgment, Speed of Thought, etc.)Emotional (Depression, Anxiety, Post Traumatic Stress Disorder, Manic episodes, etc.)Personality (Impulsivity, Recklessness, Lack of Motivation, Apathy, Withdrawal, etc.)
Diagnostics
Diagnostics guide recommendations for:Differential diagnosis (Dementia/Delirium/Depression)Treatment planningAbility to handle finances (bills, checkbook, plan, vulnerable to scam artists) Ability to make medical/legal/financial decisionsAbility to drive (Poor reaction time, spatial neglect, mentally plan for driving in high traffic conditions)Medication effectiveness (tracking cognitive/emotional/behavioral)
Memory: Word List Learning
1. Butter
2. Arm
10. Engine
Trial 1
1. Butter 1. Butter
2. Arm 2. Arm
10. Engine 10. Engine
Trial 2 Trial 3
Recognition Recall
Delayed Recall
1.
2.
10.
1. Target
20. Distractor
Memory Performance in Normals and Patients with Mild Dementia
0123456789
10
WLL R
aw
Score
Trial 1 Trial 2 Trial 3 Delay
Normal
Demented
ConsultationEnvironmental/
Physical design of facility
Behavioral management strategies for staff
Stress managementPrevention of staff
burnoutResearch-based
program design
LimitationsMedical cultureEnvironmental logisticsInsurance/reimbursementCommunication/LanguageTraining opportunities