Luthra’s Behavioral Assessment and Intervention Response (LuBAIR) Scale

Each of the twelve newly appointed behavioral categories derived from the SCRB model were used to create a new behavioral assessment tool for assessing behaviors in patients with moderate to advanced Dementia / Major Neurocognitive Disorders (D/NCD). This scale is titled LuBAIR: Luthra’s Behavioral Assessment and Intervention Response Scale. 

LuBAIR Scale has been evaluated against existing reliable and valid behavioral assessment scales, inclusive of the Cohen-Mansfield Agitation Inventory (CMAI) and BEHAVE-AD. LuBAIR Scale was determined to have comparable reliability and validity to the existing scales, is more comprehensive in data collection, and allows for behaviors to be categorized in clinically meaningful ways; thereby allowing for an understanding of the meaning for the presence of behaviors.  These results have been compiled into a manuscript which has been submitted for peer-review (July 2015). 

 

LuBAIR Page 1

How to use LuBAIR Scale

Step 1: Review clinical records of the patient referred for evaluation and identify all behavioral symptoms documented.  Match each identified behavioral symptom to the most appropriate behavioral category on the scale.  This step identifies the Quality of behaviors present in the index patient.

 

Step 2: Follow the identified Quality of behaviors over the subsequent week to determine the Severity of each Quality of behavior.  With LuBAIR Scale, behavior Severity is determined by the response of each behavior to interpersonal interventions (IPI). Severity is rated as (1) if the patient responds to IPI (sustained response to IPI), (2) if they initially respond to IPI but relapse once IPI is withdrawn (unsustained response to IPI) and (3) if they do not respond to IPI at all.

 

Step 3: Transfer the identified behavioral categories onto a Dementia Observational Scale (DOS) (also referred to as the Q15 minute observation scale).  This will provide the Frequency and Duration of each identified Quality of behavior.

 

Using LuBAIR Scale in clinical practice results in behaviors being evaluated along the following constructs;

  1. Quality of behaviors
  2. Frequency and Duration of behaviors
  3. Severity of behaviors

 

 

Future DirectionLuBAIR Page 2

The next step, in clinical applicability of LuBAIR scale, is to evaluate specific Risks associated with each Quality of behaviors identified.  Existing literature provides minimal direction on defining specific Risks in context of behaviors in D/NCD.  Mental health statues of “risk of harm to self or others” are often applied to evaluating behaviors in D/NCD.  In the clinical application of LuBAIR Scale, attempt has been made to define Risks associated with each Quality of behavior in context of D/NCD care.  All care planning to mitigate Risks can only be done in an adequate manner after identification of such specific risks.  All the aforementioned clinical principles used with LuBAIR Scale have been complied in a Clinical Handbook which will be submitted for publication to ‘Aging and Society’ in the very near future. This Handbook will guide users how to use LuBAIR Scale in clinical practice while applying the principles used to create the 12 newly appointed behavioral categories.