Assignment Question

Consider this scenario: A family has contacted you about the care of their grandfather, Juan, who has Alzheimer’s disease. The nursing home staff report that Juan engages in frequent elopement from the nursing home facility when unattended, and verbal aggression that has caused disruptions to the other nursing home residents. A review of the files shows that the nursing home contracted with a BCaBA who did not conduct a functional behavior assessment but advisedsetting limits, being consistent with rules, and blocking Juan from engaging in problem behavior. The nursing home staff decided to incorporate these strategies by restricting Juan from accessing the courtyard or roaming the halls, leaving him to stay all day in his room with only accompanied walks to therapies and the dining hall. Juan’s behaviors escalated and they have stated they will be ordering the use of chemical restraints to block occurrences of the problem behavior. For this assignment, complete the following: Consider Bailey and Burch’s (2016) risk-benefit analysis model, taught in ICS. Use this Risk-Benefit Analysis Template [DOCX] to outline the risks and benefits of a behavior analytic procedure (remember chemical restraints are not behavior analytic). Prepare a formal letter to the family with your recommendations. Include a copy of the worksheet you used with your notes to conduct the risk-benefit analysis. Analyze, within the letter, at least five BACB ethical code elements that are relevant to your discussed behavior analytic procedure and this scenario. Assignment Requirements Your assignment should meet the following requirements: Written communication: Should be free of errors that detract from the overall message. APA formatting: References and citations are formatted according to current APA style guidelines. Review the Evidence and APALinks to an external site. section of the Writing Center for more information on how to cite your sources. Resources: 2–4 recent, scholarly or professional resources. Length: 4–5 double-spaced pages, in addition to a title page and a references page. Refer to the MS in Applied Behavior Analysis (ABA) Research GuideLinks to an external site. for help finding resources. Refer to the Risk-Benefit Analysis of a Controversial Intervention rubric to ensure you understand the grading criteria for this assignment. REFERENCE Bailey, J. S., & Burch, M. R. (2016). Ethics for behavior analysts (3rd ed.). Routledge. Competencies Measured By successfully completing this assignment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria: Competency 2: Analyze ethical responsibilities related to practitioner-client relationships and practitioner-family relationships. Outline the risks and benefits of a behavior analytic procedure for the given scenario using the risk-benefit worksheet. Provide a recommendation to family members in letter format based on the given scenario. Competency 3: Evaluate assessment and intervention methods using the BACB ethical code. Analyze, within the letter, the use of a behavior analytic procedure using at least five relevant BACB ethics codes. Competency 5: Communicate in a manner that is scholarly and consistent with expectations for professionals in the field of psychology. Demonstrate an academic writing style through well-organized prose that follows assignment guidelines. Demonstrate compliance with current APA style, citation, and referencing guidelines. View Rubric Risk-Benefit Analysis of a Controversial Intervention – Rubric Risk-Benefit Analysis of a Controversial Intervention – Rubric Criteria Ratings Pts Outline the risks and benefits of a behavior analytic procedure for the given scenario using the risk-benefit worksheet. view longer description 40 to >34 pts DISTINGUISHED Fully outlines the risks and benefits of a behavior analytic procedure for the given scenario using the risk-benefit worksheet in a clear and concise manner. 34 to >28 pts PROFICIENT Outlines the risks and benefits of a behavior analytic procedure for the given scenario using the risk-benefit worksheet. 28 to >0 pts BASIC Attempts to outline the risks and benefits of a behavior analytic procedure for the given scenario, but some of the information is missing or inaccurate. 0 pts NON_PERFORMANCE Does not outline the risks and benefits of a behavior analytic procedure for the given scenario. / 40 pts Provide a recommendation to family members in letter format based on the given scenario. view longer description 60 to >51 pts DISTINGUISHED Provides a recommendation to family members in letter format based on the given scenario, and supports this recommendation with scholarly resources. 51 to >42 pts PROFICIENT Provides a recommendation to family members in letter format based on the given scenario. 42 to >0 pts BASIC Provides a recommendation to family members in letter format based on the given scenario, but does not explain the risks and benefits involved. 0 pts NON_PERFORMANCE Does not provide a recommendation to family members in letter format based on the given scenario. / 60 pts Analyze, within the letter, the use of a behavior analytic procedure using at least five relevant BACB ethics codes. view longer description 60 to >51 pts DISTINGUISHED Analyzes, within the letter, the use of a behavior analytic procedure using at least five relevant BACB ethics codes, and provides examples of conditions when the ethics codes would be met and when they would not be met. 51 to >42 pts PROFICIENT Analyzes, within the letter, the use of a behavior analytic procedure using at least five relevant BACB ethics codes. 42 to >0 pts BASIC Attempts to analyze, within the letter, the use of a behavior analytic procedure using BACB ethics codes, but includes fewer than five ethics codes or the ethics codes included are not relevant. 0 pts NON_PERFORMANCE Does not analyze the use of a behavior analytic procedure using relevant BACB ethics codes. / 60 pts Demonstrate an academic writing style through well-organized prose that follows assignment guidelines. view longer description 20 to >17 pts DISTINGUISHED Demonstrates an academic writing style through well-organized prose that contains no significant grammatical or mechanical errors and follows assignment guidelines. 17 to >14 pts PROFICIENT Demonstrates an academic writing style through well-organized prose that follows assignment guidelines. 14 to >0 pts BASIC Demonstrates minimally acceptable writing style, but still has instances of disorganization, grammatical or mechanical errors, or does not follow all assignment guidelines. 0 pts NON_PERFORMANCE Does not demonstrate an academic writing style. / 20 pts Demonstrate compliance with current APA style, citation, and referencing guidelines. view longer description 20 to >17 pts DISTINGUISHED Develops a paper that is fully compliant with current APA style, citation, and referencing guidelines. 17 to >14 pts PROFICIENT Demonstrates compliance with current APA style, citation, and referencing guidelines. 14 to >0 pts BASIC Demonstrates minimally acceptable compliance with current APA style, citation, and referencing guidelines. 0 pts NON_PERFORMANCE Does not demonstrate compliance with current APA style, citation, and referencing guidelines. / 20 pts Total Points: 0

Answer

Introduction

Alzheimer’s disease is a debilitating condition that affects millions of individuals, and it often necessitates specialized care in nursing homes. In this scenario, the family of Juan, who has Alzheimer’s disease, has sought assistance due to his problematic behaviors in a nursing home. The nursing home staff’s approach to managing Juan’s behaviors raises ethical concerns, particularly in light of their consideration of using chemical restraints. To address this situation, it is essential to conduct a comprehensive risk-benefit analysis of the proposed behavior analytic procedure, considering the principles outlined in Bailey and Burch’s (2016) risk-benefit analysis model. This essay explores the risks and benefits associated with the suggested interventions, provides recommendations to the family, and analyzes the ethical implications using the Behavior Analyst Certification Board (BACB) ethical code.

Risks and Benefits of Behavioral Interventions

The nursing home staff’s approach to managing Juan’s behaviors involves restricting his access to certain areas and implementing behavioral strategies without conducting a functional behavior assessment (FBA). While this approach may have some potential benefits, such as reducing disruptions and ensuring safety, it also poses significant risks. Restricting Juan’s movement and confining him to his room for extended periods may lead to feelings of isolation, depression, and agitation, exacerbating his behavioral issues (Bailey & Burch, 2016). Furthermore, the lack of an FBA means that the interventions may not be individualized, potentially overlooking the underlying causes of Juan’s behaviors. The proposed use of chemical restraints presents even greater risks. Chemical restraints can have severe adverse effects on an individual’s physical and mental well-being, including sedation, cognitive impairment, and increased risk of falls (Bailey & Burch, 2016). Moreover, the use of chemical restraints raises ethical concerns, as it can infringe upon an individual’s autonomy and dignity. Therefore, it is crucial to weigh these risks against the potential benefits, such as immediate behavior control, when considering the use of chemical restraints.

Recommendations to the Family

In light of the risks and benefits associated with the proposed interventions, it is imperative to provide recommendations to Juan’s family. Instead of resorting to chemical restraints, a more ethical and effective approach would be to conduct a thorough functional behavior assessment (FBA). An FBA would help identify the underlying causes of Juan’s elopement and verbal aggression, enabling the development of individualized behavior intervention plans (BIPs) that target the root of the problem (Bailey & Burch, 2016). Additionally, it is essential to involve a qualified Board-Certified Behavior Analyst (BCBA) in the assessment and intervention process. A BCBA can ensure that evidence-based practices are followed, ethical standards are upheld, and interventions are tailored to Juan’s unique needs (Bailey & Burch, 2016). The BCBA should collaborate with the nursing home staff to implement positive behavior support strategies, promote meaningful engagement, and enhance Juan’s quality of life.

Ethical Analysis

The proposed interventions in this scenario raise several ethical concerns in relation to the BACB ethical code. Firstly, the decision to implement behavioral restrictions and potentially chemical restraints without conducting an FBA goes against the BACB’s ethical guideline to prioritize the well-being and best interests of the client (BACB, 2022). Failing to identify the causes of Juan’s behaviors may result in inadequate and potentially harmful interventions. Secondly, the use of chemical restraints without proper assessment and informed consent from Juan or his family is a breach of the BACB ethical code, which emphasizes informed consent and client autonomy (BACB, 2022). Chemical restraints should only be considered as a last resort when all less restrictive alternatives have been explored.

Thirdly, the BACB ethical code highlights the importance of competence and maintaining the highest standards of professional conduct (BACB, 2022). In this scenario, the nursing home’s decision to implement interventions without consulting a qualified BCBA may be seen as a failure to adhere to these ethical standards. Additionally, the BACB ethical code emphasizes the need for ongoing assessment and monitoring to ensure the effectiveness and appropriateness of interventions (BACB, 2022). The absence of a comprehensive assessment and the potential use of chemical restraints without ongoing evaluation may lead to harmful consequences for Juan. Lastly, the BACB ethical code underscores the responsibility to protect the welfare of clients and to avoid causing physical or emotional harm (BACB, 2022). The proposed interventions, particularly the use of chemical restraints, may expose Juan to significant physical and emotional harm, which is inconsistent with these ethical principles.

Assessing the Ethical Implications

The assessment of the ethical implications in the case of Juan’s care involves a comprehensive analysis of the Behavior Analyst Certification Board (BACB) ethical code. The BACB’s ethical code sets forth guidelines and principles that behavior analysts must follow to ensure ethical practice in their interactions with clients, including individuals with Alzheimer’s disease like Juan. First and foremost, the BACB ethical code emphasizes the paramount importance of promoting the welfare of clients (BACB, 2022). In the case of Juan, the decision to restrict his movements and consider chemical restraints without conducting a functional behavior assessment (FBA) raises concerns about whether his best interests and well-being were genuinely prioritized. The ethical principle of prioritizing client welfare suggests that all interventions should be aimed at improving Juan’s quality of life and addressing the underlying causes of his behaviors.

Another critical ethical consideration is the principle of informed consent and client autonomy (BACB, 2022). Juan and his family should have been provided with comprehensive information about the proposed interventions, including the potential risks and benefits. Additionally, they should have been actively involved in the decision-making process, allowing Juan to exercise his autonomy to the fullest extent possible. The potential use of chemical restraints without informed consent raises ethical concerns, as it may infringe upon Juan’s right to make choices about his own care. The BACB ethical code also underscores the importance of maintaining competence and adhering to the highest standards of professional conduct (BACB, 2022). In this case, the nursing home staff’s decision to implement interventions without consulting a qualified Board-Certified Behavior Analyst (BCBA) may be viewed as a breach of these ethical standards. BCBA professionals are trained to conduct FBAs, develop individualized behavior intervention plans, and ensure that ethical practices are followed. The absence of a BCBA’s expertise may have contributed to the inadequate and potentially harmful interventions proposed.

The BACB ethical code highlights the need for ongoing assessment and monitoring to ensure the effectiveness and appropriateness of interventions (BACB, 2022). In Juan’s case, the lack of an FBA and a systematic approach to evaluating the success of the interventions can lead to unintended consequences. Ethical practice requires that interventions be regularly assessed and modified as needed to better meet the client’s needs. Lastly, the BACB ethical code places a strong emphasis on the responsibility to protect the welfare of clients and to avoid causing physical or emotional harm (BACB, 2022). The proposed interventions, particularly the potential use of chemical restraints, may expose Juan to significant harm. It is crucial for behavior analysts to consider the potential adverse effects of interventions and prioritize safety and well-being.

Conclusion

In conclusion, the case of Juan, an individual with Alzheimer’s disease facing problematic behaviors in a nursing home, necessitates a thorough ethical analysis of the proposed interventions. A comprehensive risk-benefit analysis of the behavioral interventions highlighted the potential risks and benefits associated with these strategies. Recommendations to Juan’s family included the importance of conducting a functional behavior assessment, involving a qualified BCBA, and prioritizing less restrictive and more individualized interventions. The ethical analysis, based on the BACB ethical code, revealed several ethical concerns, including the failure to prioritize the client’s well-being, the potential infringement upon client autonomy, and the lack of competence in implementing behavior analytic procedures. It is crucial for professionals in the field of applied behavior analysis to adhere to ethical guidelines and prioritize the welfare of clients like Juan. By doing so, they can ensure that individuals with Alzheimer’s disease receive the highest quality of care that respects their dignity and autonomy.

References

Bailey, J. S., & Burch, M. R. (2016). Ethics for behavior analysts (3rd ed.). Routledge.

Behavior Analyst Certification Board (BACB). (2022). Professional and ethical compliance code for behavior analysts.

Frequently Asked Questions (FAQs)

Q1: What is the scenario presented in this assignment?

A1: The scenario involves a family seeking help for their grandfather, Juan, who has Alzheimer’s disease and exhibits challenging behaviors in a nursing home.

Q2: What are the potential risks associated with the proposed behavioral interventions for Juan?

A2: The potential risks include increased feelings of isolation, depression, agitation, and the use of chemical restraints, which can lead to adverse physical and cognitive effects.

Q3: What recommendations can be provided to Juan’s family in this situation?

A3: Recommendations include conducting a functional behavior assessment, involving a qualified Board-Certified Behavior Analyst (BCBA), and prioritizing individualized and less restrictive interventions.

Q4: How does the BACB ethical code come into play in this scenario?

A4: The BACB ethical code is relevant in assessing the ethical implications of the proposed interventions, highlighting concerns related to client well-being, autonomy, competence, ongoing assessment, and the avoidance of harm.

Q5: What are the potential consequences of not following ethical guidelines in this case?

A5: Failing to follow ethical guidelines may result in inadequate care, potential harm to Juan, and a breach of professional conduct standards in applied behavior analysis.