History, Development, and Future of the Progressively Lowered Stress Threshold: A Conceptual Model for Dementia Care

Behavioral symptoms associated with dementia are a major concern for the person who experiences them and for caregivers who supervise, support, and assist them. The knowledge and skill of formal and informal caregivers affects the quality of care they can provide and their ability to cope with the c...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) 2004-10, Vol.52 (10), p.1755-1760
Main Authors: Smith, Marianne, Gerdner, Linda A., Hall, Geri R., Buckwalter, Kathleen C.
Format: Article
Language:English
Subjects:
Aged
Behavior
Biological and medical sciences
Caregivers
Caregivers - psychology
Carers
Challenging behaviour
Conceptual models
Coping strategies
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Dementia
Dementia - history
Dementia - nursing
Elderly people
General aspects
Geriatric Nursing - history
Geriatric Nursing - trends
History, 20th Century
Humans
Medical sciences
Models, Nursing
Neurology
Nurses
Progressively Lowered Stress Threshold model
Stress
Stress, Psychological - etiology
Stress, Psychological - prevention & control
Training
United States
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Summary:Behavioral symptoms associated with dementia are a major concern for the person who experiences them and for caregivers who supervise, support, and assist them. The knowledge and skill of formal and informal caregivers affects the quality of care they can provide and their ability to cope with the challenges of caregiving. Nurses are in an excellent position to provide training to empower caregivers with the knowledge and skills necessary to reduce and better manage behaviors. This article reviews advances in geriatric nursing theory, practice, and research based on the Progressively Lowered Stress Threshold (PLST) model that are designed to promote more adaptive and functional behavior in older adults with advancing dementia. For more than 17 years, the model has been used to train caregivers in homes, adult day programs, nursing homes, and acute care hospitals and has served as the theoretical basis for in‐home and institutional studies. Care planning principles and key elements of interventions that flow from the model are set forth, and outcomes from numerous research projects using the PLST model are presented.
ISSN:0002-8614
1532-5415
DOI:10.1111/j.1532-5415.2004.52473.x