Wednesday, 20 December 2017 08:29

Behavioral Intervention for Luther Featured

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Summary of Case

The case focuses on Mr. Luther; an 80 years old man admitted to a nursing home for the first time. Luther has Alzheimer’s diseases and with the progression of the disease his wife found it best to send it to a nursing home. However, at a nursing home, Luther has acquired the peculiar behavior of walking outside, by himself. When Luther began to exhibit the behavior, the nurses thought the behavior could be associated with his Alzheimer’s which interferes with his memory. In many instances, Luther has been warned against going outside alone, but he repeats the same behavior. After conducting a functional assessment, it emerges that Luther is regularly walking outside, as an attention seeking strategy. Luther has found himself in an environment where his freedom is controlled and where attention is divided among other residents. He thus establishes a behavior that he is sure would attract the attention of the nurses. Each time he goes out a nurse runs after him and bring him back to the home thus spending approximately five minutes with him over a cup of coffee or cookie.

Interview Summary

An interview for staff members revealed that Luther has acquired the habit of walking out of a nursing home. The interview further reveals that he has tested different doors and settled for the front door where the nurse station is located. From an interview, it is apparent that the nurses have noted Luther’s behavior and thus, in most instances stop him from going outside before he initiates the behavior (Miltenberger, 2011). The interview also reveals that Luther lingers by the door for some few minutes before eventually walking out. Additionally, the interview reveals that Luther exhibits the walkout behavior when the nurses are very busy such as meal times and when nurses are providing care routines. The interview also reveals that the nurses have been consistently informing Luther not to repeat his walkout behavior. However, it is evident that the strategy is not effective.

ABC Data Summary

It is evident that Luther craves for attention. Luther must have noted that he gets the attention he craves for when he walks out of the door. When Luther began exhibiting the behavior, he used different doors leading out of the house. However, he settled for the door near the nurse's stations after realizing that the other doors were not resulting to his target outcome. When he went to through the courtyard door, for instance, the nurses did not follow him as he courtyard was a safe environment.

When Luther failed to get his target result through the courtyard door, he opted to use the front door. He acquired his target purpose when he used the front door. When he uses the front door near the nursing station, the nurses either stop him from leaving or rush out to get him back in the house. In the process, Luther gets to spend a few minutes with the nurse. It is evident that Luther craves for attention and has devised the behavior of leaving the house to get the nurses attention. Efforts to advise him to change his behavior have not been successful as each time he leaves; he acquires the reinforcement he desires. The behaviorist must establish the ideal intervention strategy that will ascertain he changes his behavior. Redirection has been suggested as ideal behavioral intervention method.

Analysis of Redirection as a treatment Intervention

Redirection is a behavioral intervention strategy that focuses on finding an alternative to inappropriate behavior. With the redirection, the individual replaces the unpleasant behavior with the new behavior thus marking the end of the undesirable behavior. When Luther is redirected to another activity, he is likely to stop walking out thus minimize the risk he exposes himself to when he walk out. Luther craves for attention hence the likelihood that he is lonely. Luther can be exposed to painting session, dancing sessions or playing soft-games like pool or a game of cards. The main advantage with the use of redirection is that Luther will finally get the attention he is craving to get. When playing the games or participating, in art, he will get the company and attention he desires. Luther will thus stop the behavior of walking out thus reduce the risk associated with the behavior (Miltenberger, 2011). When Luther goes out, he risks exposing himself to colds especially when he walks out without warm clothes. The risk of injuries also heightens when he walks outsides without supervision. The introduction of alternative interesting games minimizes the health threats.

The main disadvantage with the use of redirection is that the nurses may overlook the actual cause of Luther’s continued behavior. Luther has Alzheimer’s thus puts him at risk of memory loss. The nurses have indicated that they have talked to Luther, numerous times over his undesirable behavior, but he keeps repeating the same behavior. Whereas the nurses and the behaviorists may assume that Luther is suffering from a behavioral issue, it could be that his Alzheimer’s is progressing faster than anticipated thus increased memory loss. With increased memory loss, Luther forgets very quickly thus instructions on behavior change are ineffective (Perce, & Cheney, 2013). The application of redirection as a behavior changing strategies is intricate as the behaviorism must establish and solve the cause of the behavior. Luther may be depressed due to his placement at a nursing home. If Luther is depressed, the nurses must establish means to assist Luther accept his status rather than introducing behavioral intervention measures.

Promoting Generalization

The behaviorist and the nurses can strive to encourage generalization to promote appropriate behavior. A behavior is categorized as generalized if an individual exhibits trained behavior even without supervision or without retraining. Generalization increases the likelihood that behavior change will occur within a person’s life. Generalization can occur through reinforcement of behavior. In the case of Luther, for instance, the nurses can reinforce Luther through praise when he spends a day without leaving the facility. Alternatively, nurses can spend some time with Luther if he completes the day without stepping outside. Positive reinforcements encourage the individuals to repeat the behavior that resulted to the rewards thus elimination of the undesirable behavior. Alternatively, nurses can train Luther on alternative skills that will result to the end of the undesirable behavior. Luther can, for instance, be trained how to paint thus spend time with the peers painting rather than seeking attention. Lastly, the nursing home can modify the possible circumstance of reinforcement for desirable behavior. Luther walks out because he craves for attention, and the nursing home can hire more nurse assistants to engage the residents in various social activities (Perce, & Cheney, 2013). Luther will get the attention he desires; he will have eliminated boredom and will cease walking out of the home.


Miltenberger, R. (2011). Behavior Modification. Cengage learning

Perce, D. & Cheney, C. (2013). Behavior analysis and learning. Psychology press

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