In reviewing the literature on the use of behavioral therapy, Smyer, et al concluded that behavioral approaches involving the application of learning principles have been demonstrated to be effective as an intervention technique with the elderly for a variety of problems in a variety of settings. Specifically, studies have been reported in the literature that suggest that a behavioral approach can be applied to mediate certain behaviors of dementia patients. When using behavioral approaches, it is important to remember that the behavior of organisms is maintained by reinforcement. That is to say, if a person exhibits a behavior, it is because the behavior is meeting a need. For the behavior to be changed, either the need has to be satisfied by a different behavior, or the behavior has to have a different consequence. Behavioral approaches are extremely powerful in maintaining and changing behavior and often occur coincidentally. To change behavior purposefully, it is important to keep in mind that the meeting of needs by a different specific behavior or the reinforcement of a new behavior needs to be consistent for the entire daily environment. Despite the fact that research supports the effectiveness of behavioral interventions for specific behavioral problems, these strategies have not seen widespread use in nursing home settings. Another reason for the limited use of behavioral approaches may be that nursing home professionals are not aware of the effectiveness of such interventions. Other reasons for the limited use of behavioral approaches in long-term care settings may be that implementation requires not only caregiver training, but also consistent maintenance of appropriate environmental contingencies.(ABSTRACT TRUNCATED AT 250 WORDS)