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Adult learning process is very different from the one people experience in the school and university educational system. The latter ones are structured by authorities of various types, while the process of the former one is massively self-managed. Adult learners are interested in topics that are more challenging for them, as well as they prefer to create own working schedule and timetable (Tough, 1979). But even independent learning process requires structure and a set of deadlines, which will help to organize and manage work in a best way possible, in order to avoid rushes or delays. Moreover, adult learners need stimulation not only in the form of deadlines, but they are also seeking for some kind of a moral and educational satisfaction that is grounded in their interests. Therefore, in order to understand the reasons for studying a subject one should define the goals and objectives, the ways to achieve them, as well as the methods to be used in the process.
This paper analyzes four learning objectives for the study of different methods of BPSD treatment. First two objectives define the two main directions of the study: pharmacological and non-pharmacological interventions. The third objective defines the goal of the research, which is a composition of a manual on different forms of BPSD treatment. Lastly, the ultimate objective of this study is the possibility to share the most recent information on the disease and various methods of treating it with all interested parties: healthcare professionals, caretakers, family members, and even the patients. Methods and techniques of this research, as well as its’ goals are shaped by the four objectives mentioned earlier.
Learning contracts have become an essential element of adult learning and an integral part of independent studying, as well as modern education. Although the concept was developed not so long ago by Malcolm Knowles who was working on educational theories back in 1980s, currently learning contacts have deeply rooted in educational concepts (Brockett & Hiemstra, 1991). Learning contracts are usually used in adult learning in order to mix existing experiences with the desire to gain new knowledge thus filling the gap between the amount of information that has already been acquired by the person and the required knowledge s/he wants to gain. Knowles (1986) has defined his idea of learning contracts as a grouping of the five elements described further.
The first one consists of various skills and values acquired by the learner and is in fact defined as “learning objective”. The second element defines the ways in which learning objectives are achieved and can be called learning resources (or strategies). The third one defines timing and key dates for accomplishing goals. The fourth element presents evidence of achieving objectives, while the last one demonstrates the accuracy of evidence and ways of its’ judgment.
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It is clear that for the concept of adult education, the process of which is usually managed by the learners alone, learning contracts play a truly significant role. While understanding own learning and cognitive styles and using the learning contracts one is able to determine the goals and steps of the learning process. The four learning objectives developed below show one of the examples of the implementation of learning contracts on practice.
Behavioral and psychological symptoms of dementia create the biggest problem for patients with various forms of dementia, as well as their caretakers. These symptoms include aggression, agitation/restlessness, hallucinations, delusions, sleep disturbance, wandering, etc. All these behaviors have been defined as complicated and challenging, thus requiring a person-centered approach to treatment.
The first objective is the study of non-pharmacological treatments of BPSD from different points of view: benefits and drawbacks of existing treatment options, the roles of patient and caregiver, and the results one can achieve by using this type of treatment for BPSD patients. Tampi et. al. (2011), Kar (2009), and Burns, Byrne, Ballard & Holmes (2002) identify various types of non-pharmacological interventions, such as nursing and behavioral interventions, aromatherapy, social interactions etc. On the contrary to pharmacological treatment, these interventions help to improve of living conditions of patients on the earlier stages and thus avoid treatment with medication. Scholarly resources create the basic knowledge of different intervention types, the history of their success and failures. After the research it is essential to get some more practical information from professionals working with BPSD patients in various communities. The theoretical knowledge acquired during the process of learning will further be shared with BPSD professionals and caregivers who might still be unaware of the significant role of some of the methods. Even the caregivers who spend a lot of time with BPSD patients might not be aware of the latest techniques in BPSD treatment. Therefore, by conducting an in-depth study of various non-pharmacological treatments the researcher will be able to provide caregivers with new and necessary information.
As well as non-pharmacological treatment, various pharmacological interventions play a significant role in the treatment of BPSD and its’ symptoms. Antipsychotic medication is the main form of pharmaceutical treatment Moreover, medication leads to potential adverse effects; therefore this treatment should be carefully executed with elderly patients. This form of treatment is recommended only when alternative options appear to be ineffective (Burns, Byrne, Ballard & Holmes, 2002). The second objective of this research is to gather different points of view on various BPSD medications (Carejeira, Lagarto, & Mukaetova-Ladinska, 2012). This study will combine two methods: research that will help to gather materials on the issue, and meetings with specialists working with BPSD patients. It is always better to get pharmacological information from people with appropriate education, thus for this type of the research there will be no interviews with caregivers. Pharmacological treatment requires much more theoretical knowledge than the non-pharmacological one due to the much more significant level of harm it can cause to the BPSD patient and only in cases when people suffer significant distress from the symptoms (Lee et al, 2004). Therefore, while the non-pharmacological research will be focused on the variety of treatments and their results, the pharmacological one will include an in-depth study of each medication used for treating BPSD. The results of this study will be especially useful for caregivers who lack the true understanding of various medications that should or should not be used for different types of BPSD treatment.
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Although a lot of researches were conducted on BPSD and various types of treatment, a unified manual that includes all the latest pharmacological and non-pharmacological interventions is required in order to make the lives and work of caregivers and BPSD specialists easier. Of course, there are already different manuals on the topic, such as the ‘Best Practice Guideline for Accommodating and Managing Behavioural and Psychological Symptoms of Dementia in Residential Care’ issued in 2012 in British Columbia. But the new manual is required each year due to the constant development in the sphere. Moreover, after reviewing the existing guides as well as scholarly resources on the topic, it will be possible to include all the information on various BPSD treatments in one document. Pharmacological and non-pharmacological interventions will be in the focus of the new manual, which will help caregivers and BPSD specialists oversee all the treatment possibilities and choose the appropriate ones.
Finally, the last learning objective for this study is to share the knowledge gained in the process of this research with all the interested groups: healthcare professionals, caretakers, family members of BPSD patients. This is a chance to share knowledge gained through the process of research and analysis and thus give a possibility to the wide public to implement everything that was so far in a theoretical form, on practice. The main way to achieve this goal is to share the manual comprised in the process of this research with as many people as possible. BPSD centers, such as the Alzheimer Society of Toronto (2013), can be one of the target groups for knowledge sharing. Taking into consideration the fact that some of the BPSD-focused organizations already have their learning programs (one example – the e-learning program of the Alzheimer Society of Toronto) this plan will not be hard to implement. The second target group is comprised of the educational institutions that have BPSD as one of the educational subjects. BY approaching educational institutions and learning centers it will also be possible to reach individual caretakers and family members of patients with BPSD.
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Adult learning process differs from the one people experience in schools and universities. An individual has more control over the learning process as an adult not only by creating own working schedule and defining methods of study, but also by being able to state all the goals and issues that s/he finds the most interesting. In order to manage and organize the process of adult learning Malcolm Knowles created the concept of learning contracts back in 1980s. Learning contracts define the structure of acquiring knowledge through the definition of learning objectives, statement of methods that will be used while achieving them, defining the deadlines and timeline, and finally – the justification of evidence achieved through the process of the study.
After the theoretical definition of learning contracts this paper focuses on the four learning objectives defined for the study of BPSD treatment methods. The first two objectives clearly describe the main fields of the research: pharmacological and non-pharmacological treatment, while the latter two focus on the implementation of knowledge gained in the process of this research. While studying the various methods of treatment pharmacological interventions will be given much more in-depth attention due to their possible harm for the patient’s health. Non-pharmacological treatment is a better option in order to improve the living conditions of patients and avoid further pharmacological interventions. But in cases when alternative treatment is not efficient and patients experience strong distress from the symptoms, pharmacological methods are being used. All the gained knowledge will be combined in one document that is aimed to be spread among those working or living with BPSD. Therefore, all the theoretical knowledge gained in the process of this research will be implemented on practice by caretakers and healthcare professionals across the country.