Dr. Atul Sunny Luthra is an associate clinical professor at McMaster University in Hamilton, ON, Canada, and a research scientist with the Research Institute for Aging, Schegel-University of Waterloo. Presently he serves as the Medical Coordinator in the Program for Older Adults at Homewood Health Centre in Guelph, ON, and works in the same capacity at St. Peter’s Hamilton Health Science in Hamilton, ON. His clinical and research focus is on developing safe pharmacological and effective non-pharmacological treatment interventions in moderate and advanced dementia.
Classification of Behaviors In Dementia Based in “Motivational” and Needs Based Theories
There is vast heterogeneity in use of terminology and classification of behaviors in dementia with no universally accepted classification system.
Classify behaviors in dementia based on impairment in “motivational” and “needs based” theories.
Criteria proposed by Davis, Buckwalter and Burgio (1997) were identified as the basis for classification of behaviors in dementia. A review of literature was done with a view to identify the “Specification of the Theoretical Construct” to justify aggregation of similar behavioral symptoms into clinically meaningful categories.
“Specification of the Theoretical Construct” identified for these behavioral categories are motivational and needs based theories. Behavioral categories emanating from these constructs are: Apathy Behaviors (AB), Goal Directed Behaviors (GDB), Motor Behaviors (MB), and Importuning Behaviors (IB).
Apathy behaviors are the result of a decrease in the motivational drives with an absence of any need fulfillment. Goal-Directed Behaviors are the result of an increase in motivational drives with increase in detection and fulfillment of “belongingness” needs. Motor behaviors are the result of varying degrees of changes in motivational drives and are concomitants to other behavioral categories. Importuning behaviors are the result of preserved motivational drives in detection and fulfillment of “physiological needs”. Understanding the meaning behind behaviors in dementia, based on classifications founded in theoretical constructs that are well established in psychological literature, allows for the development of individualized care plans that can be incorporated into policies and procedures and institutional guidelines in long-term care, in order to improve person-centred care.