This websites opening page
Behavioral Programs
The page you are viewing
Self contained kits you use for staff in-service
Notebooks, interactive CDs & consulting services
Alternative ways to start and utilize our programs
Existing & anticpated studies on program efficacy
Existing client upgrades and  new intervetions & programs



 Research Based
 Behavior Management Programs                                                  
We provide integrated, easy to use, behavioral programs professional caregivers use: 
to moderate behaviors expressed by 90% of dementia patients.
improve the quality & cost of dementia care
exploit unused staff capabilities through self-managed, team programs
reduce psychotropics, polypharmacy, adverse reactions, side effects & falls                                               
Programs are avialable for an individual patients, patient groups or whole care units. All
programs are indivualized for current needs against future performance goals.  
THERAPY FOR AN INDIVIDUAL
THERAPY  FOR SMALL GROUPS
A program enabling caregivers avoid or reduce specific behaviors  exhibited by a specific dementia patients... read more
Programs to assist caregivers in the management of behavior of small groups of dementa patients... read more
THERAPY FOR A SPECIAL CARE UNIT
THERAPY FOR AN ORGANIZATION
Programs assisting in development of a non-pharmacological dementia therapy approach of dementia therapy for staff of one care unit... read more
Programs designed to push down care responsibility and enhance care management through the use of care teams... read more
 
Just in Time - Individual Resident Therapy
Most professional caregivers realize 80% of behavior problems are caused by 20% of
dementia patients. We provide "Just Enough" kits to help aides solve these problems.

Each kit is produced for a specific resident and designed to enable their key aides to plan, execute and evaluate an appropriate non-pharmacological program. We have found, to most skeptical clinicians, seeing is believeing. Therefore we have arranged for caregivers to recieve
a risk free trial of our individual patient therapy. Click here for more information on a trial.

Each Individual Patient Therapy kit contains:
4 CDs of individualized, engineered music to capture and hold that patients wounded conscious processing
Suggested non-pharmacological interventions to use to avoid or minimize the behavior
Reference & research about the behavior and it's caues
Training materials to train aides and have a care team select & use interventions
Care support materials to, plan execute and evaluate the interventions

See Behaviors & Individual Interventions covered with individual resident therapy.


 
Small Group Dementia Therapy Programs
The 80/20 rule may also apply to times of the day when multiple residents exhibit
behavioral symptoms in concert. Often this is when:
staff is occupied with other duties,
the care unit is short staffed,
residents are fatigued,
the environment uncontrollably over or under stimulating.  

Our group interventions are designed to be used in anticipation of this times to reduce or
eliminate resulting group or individual behaviors. To determine the need for or design of group
programs please call our tool free 800 734 6186. We will set up a time during which you
can discuss your current situation with our case manager.

After a discussion of your current situation our case manager designs a kit of materials
you can use to plan, implement and adjust a small group program. Each kit contains:

An approiate number of CDs of engineered music individualized for your group needs
A clinical explanation and reference of behaviorcause & suggested alternative solutions
SmartChart training materials your caregivers use      to build a team intervention
Care support materials to, plan, execute and evaluate the group interventions


Virtually all of our group programs were developed to meet a specific need of our clients:

Our dining program was developed to meet the needs of a facility who's existing dining
       efforts required more labor than was available to them.
Our comfort zone program was developed for a PACE site who needed to avoid placement
       of an excessive number of participants in skiled nursing facilities  
Our polypharmacy program was developed to reduce chronic vocalization in a resident
       which prevented her from having a roomate and the administrator filling an available bed.
Our pseudo-religious programs were developed for aged nuns who could no longer
       participate in conventional services but benefited from reduced stimulation services.     
Our sunbdowners and reminiscence programs were developed to provide diversion
       for skilled nursing facilities who had excessive behavior problems on 2nd shift.

If you feel you have a specific problem with unwanted behaviors not currently covered by
us please call us to discuss your needs on our toll free line  (800) 734 6186

 
Non Pharmacological Dementia Therapy for a Special Care Unit
We define a Special Care Unit as any organization caring for multiple people with dementia seeking to improve the cost effectiveness of that care. A special care unit can be a nursing unit
in a long term care facility, a PACE program or a conventional Adult Day Care Center.

For each organization we provide the tools and training that allow the unit staff  to  learn, plan and deploy a program of non-pharmacological dementia therapy. With our help a program is set in motion which uses teamwork and self management to push appropriate dementia care to the people who interact with the patients.

Often this is done after successful experience with a trial of an individual patient "Just Enough"
kit; when an organization wants to bring the benefits of non-pharmacological dementia therapy  to multiple individuals or groups of individuals.

Unlike "Just Enough" this program, called Special Care Utilities, is built from our inventory of all interventions, training and support programs to allow you to bring benefits to all people in your unit's program. Components of any clients program are based on current operations performance and your units future goals.

To insure cost effectiveness we request that all clients purchasing this program first successfully
deploy a least one "Just Enough" individual therapy program. This allows both of us to understand
the actual requirements and benefits of non-pharmacological dementia therapy program in designing and deploying a program.


 
Therapy for an entire care organization
Changing a culture is a popular but difficult goal to achieve. We have found it can be best achieved through slow, progressive expansion of non-pharmacological dementia therapy.

Beginning with one patient at a time and then moving to enlighten one care unit at a time allows you to change your care culture on a "pay as you go" basis. This sequential approach is less dramatic than more expensive culture programs but incurrs less risk and a higher chance of success. However, for those organizations wanting to change to a more patient centered care we do offer a program which begins with a two day team planning retreat for key executives and ends with the implementation of concurrent care unit's implementation. Please call our office to discuss this program in more detail. (800) 734 6186

 
Behaviors & Interventions Covered by Just Enough Kits
The following is a list of topics covered in our Just Enough Program. Just Enough Kits conentrate
on simple,mostly engineered music interventions to moderate behavior. Below is a chart showing
behaviors covered, interventions provided and measures of efficacy.
Behavior
Prescription
Performance Measurement
Morning Disorientation
Resident disoriented upon awakening, increased morning care difficulty
Play preferred Morning CD 15 minutes prior  to beginning care. Wake slowly, gently with complements
Reduced agitation in approach
Improved compliance in 1st ADL
Improved mood, cooperation
Reduced CNA time/stress
Dependent/Resistive ADLs
Resident is over stimulated
ADL is overly demanding
Conflict between habit and ADL (e.g. schedule/steps/processes)
ADL generates patient pain or impacts modesty
Play any 10-15 minutes preferred CD prior to beginning ADL. Approach with complement. Reduce request pace/complexity
Inconsistent caregiver instructions
e.g. use ADL Ritual
Improved compliance
Reduced patient negative reactions/incidences
Reduced CNA risk/time/stress
Reduced psychotropic meds use
Refusing medications/food
Resident is over stimulated, distracted and/or paranoid
Play any Dining CD 10-15 minutes before serving, during & after providing food/medication
Reduced meds refusal
Improved time spent eating
Increased food intake
Reduced digestive/stim med use
Positive weight gain
Evening Disorientation
Resident disoriented
Circadian rhythm disrupted
Resident afraid of dark/room
Play any Evening CD
Build CD into “bedtime ritual”
Enforce ritual use every evening
Reduced resistance to bedtime
Reduced caregiver time
Longer restorative sleep time
Not Sleeping at Night
Resident gets up after going to bed, may refuse to go back to bed
due to under stimulation or confusion after going to bathroom
Play preferred Evening CD using repeat play button
Redo bedtime ritual when they get up referring them to music playing
Increased nighttime spent in bed
Reduced fatigue/sundowning
Reduced risk incidence of falls
Reduced psychotropic use
Wandering/Repetitive Vocalization
Resident bored & self stimulating
Resident over stimulated
Resident under stimulated
Map behavior for time & place
Prior to time/place play any most preferred Engineered Music CD
Schedule companionship/walk
Reduced  time wander/vocalizing Reduced falls/incidence reports
Reduced intrusions/hoarding
Apathetic/Withdrawn
Resident depressed/disconnected
Current environment is either over/under stimulating
Play Holiday/General CDs
Use music to build bridge
Graduate to Morning CDs/activity
Increased engagement
Reduced psychotropic meds
Above Average Illness/Infection
Resident feels chronic confusion and stress. Excess cortisol reduces immunity
Reduce disorientation using multiple, appropriate CDs daily
(elevate melatonin/lower cortisol)
Reduced medical visits
Reduced medications
Improved independence
Polypharmacy/Side Effects/ADRs
Drug reactions/interactions increase dementia behavioral symptoms
Introduce Engineered Music in lieu of new prescription or use music to build drug holiday trial
Reduced “chemical” confusion
Reduced psychopharm use/cost
Reduced psych visits/expense
MDs/OT/PT/ST Non compliance
Resident rejects or misunder-stands clinicians requests & lacks attention to focus on instruction
Play favorite CD prior to request
Play appropriate Engineered Music during session
Improved course of treatment
Improved reimbursement
Improved compliance
 
Behaviors and Group Interventions

Behavioral Explanation
Prescription
Performance Measurement
Sundowners Prevention Group Residents become agitated at shift change due to a combination of fatigue and over stimulation
Bring sundowners to an insulated, remote room30 minutes prior to shift change. Provide a snack and have them listen to engineered music until 30 minutes after shift change
Reduced agitation and nursing requirements caused by commotion caused during shift change
Pseudo religious ceremony
Residents suffer from paranoia and hyper vigilance due to chronic confusion, but unable to attend conventional religious ceremonies
Gather residents with similar religious backgrounds and play appropriate, engineered ,religious music. Repeat the most familiar prayers of that religion e.g. Hail Mary's, Nicene Creed, The Lords Prayer, the Kaddish
Reduced agitation
Reduced behavioral symptoms
Relaxation
Reduced depression
Dining Program
Residents with moderate to sever dementia become over stimulated during dining. This cause agitation, excess dependence, poor eating and digestion
Rate all residents in terms of dining needs and abilities. Bring high dependency residents to a smaller quieter room. Play general Dining engineered music
Increased food consumption
Increased time spent in dining
Increased independence
The Comfort Zone
Some residents/participants are not comfortable in any conventional environment. They spend the day agitated and exhibiting a variety of behaviors
Identify at least 8 people who would function better in a highly structured, low stimulation environment. Provide a highly repetitive program of daily activities in an isolated room using one caregiver with assistance for meals and toileting
Pull that 20% of residents that are requiring 80% of nursing attention off the unit.
Increased resident participation
Decreased resident agitation
Improved eating
Reduced illnesses & co morbidity
Reminiscence Program
Finding activities that hold the attention of people with severely impaired cognition and memory is difficult
We provide a CD with a progression of songs seniors have heard from childhood to adulthood. Playing the music to small groups can trigger memories and induce conversation
Did they participate in discussion
Polypharmacy Program
Using non-pharmacological dementia therapy to wean residents off of excess psychotropic medications
Working with a resident's physician or psychiatrist we build interventions which reduce agitation or unwanted behaviors and reduce prescribed drugs
Is the patient overmedicated ?
Has there been measurable behavior improvement recorded (MDS etc.)?
Has the number, titration or psycho-activite components been reduced ?

 
Behaviors, Interventions & Support Services covered for a single care unit

Behaviors Covered
Interventions Covered
Support Services Covered
Aggression     
Anger
Anxiety
Apathy/Withdrawal
Catastrophic Reaction
Delusion/Hallucination/Misidentification
Excess Illness
Eating & Digestion Problems
Dressing/Undressing
Intrude, Hide, Hoard,  Shadow
Incontinence
Morning Disorientation
Polypharmacy
Resists Meds and/or Care
Sexual Difficulty
Sleeping Difficulty
Evening Disoientation/Sundown
Verbal Disruption, Confabulation,
Wandering
Behavior Modification
Clothing Modification
Busy Box/Cognitive Bins
Doll Therapy
Engineered Music
Environment Modification
Family Caregiver Education
Hand Massage
Modified Communications
Modified Work
Modified Positioning
Photo Album
Pseudo-religious Ceremony
Rocking or Glider Chairs
Social Dancing
Singing Leverage
Simulated Presence
Therapeutic Touch
Reimbursed Therapy
Pre-Intervention Activities
  Facilitiy & Care Assessment
  Competitive Assessment
Kick-off Programs
  Dementia Simulation
  Best of Everything
  Make a Miracle
Nurse Management Programs
  Back-up analysis
  Team & Esteem Management
Training Programs
  SmartCharts (team training)
  Train the trainer
Staff motivation/retention Programs
  Catch them doing it right
  Caregiver pairings programs
Family/Community Programs
  Community Outreach

 
How to Set Up a Risk Free Trial
You can order a risk free trial by calling a case manager on our toll free number 800 734 6186
If you are calling after our office hours (8:30AM to 4:30 Eastern Zone Time) just leave a time & day when you would like us to call you back and a number at which you can be reached.

When you do talk to our case manager you will need to have as much the following information available as possible. Remember residents who we can help have:
a diagnosis of moderate to severe dementia
exhibit one or more behavior problems

You and your case manager will discuss as much of the following information as possible:
Your name, facility name and mailing address
A HIPPA appropriate resident identifier (e.g. first name or room number)
Age of the resident  
Type of behavior problem(s) this resident exhibits
Residents religion and estimated degree of importance to resident
Known or estimated music genre preferences
Ethnicity or geographic area where resident spent their youth
Any extenuating circumstances

At the end of this discussion our case manager will:
Determine if they think your resident is appropriate for non-pharm interventions
Open an account with your facility
Identify and produce 4 CDs of Engineered music specifically for your resident
Select appropriate training materials for you to use to implement a test program
Select measures of performance you can use to track efficacy
Mail these materials to you & call to make sure you recieved them
Call back, at a prescheduled time, 7 days later to check efficacy

If after 7 days:
you wish to keep our materials your account will be charged $250.
you wish to add additional residents, groups or nursing units your account will be
       charged $200 and 20% off of list price for any additional purchases
you do not wish to keep our materials, ship them back and your account will not
       be charged anything.