Below is a list of resources pertaining to the Progressively Lowered Stress Threshold (PLST) model. 

Developed by the late Dr. Geri Hall and Dr. Kathleen "Kitty" Buckwalter, the PLST model was designed to educate formal and informal caregivers about the progression of dementia and associated behaviors to help inform plans of care. 

Please reach out to with any questions. 


PLST Caregiver Resources

Resources for caregivers related to the Progressively Lowered Stress Threshold (PLST) model.


Research Articles

  1. Hall, G. R., & Buckwalter, K. C. (1987). Progressively lowered stress threshold: A conceptual model for care of adults with Alzheimer's disease. Archives of Psychiatric Nursing, 1(6), 399-406.

  2. Hall, G. R., & Buckwalter, K. C. (1991). Whole disease care planning: Fitting the program to the client with Alzheimer's disease. Journal of Gerontological Nursing, 17(3), 38-41.

  3. Hall, G. R., Gerdner, L., Zwygart-Stauffacher, M., & Buckwalter, K. C. (1995). Principles of nonpharmacological management: Caring for persons with Alzheimer’s disease using a conceptual model. Psychiatric Annals, 25(7), 432-440.

  4. Gerdner, L. A., Hall, G. R., & Buckwalter, K. C. (1996).  Caregiver training for people with Alzheimer’s based on a stress threshold model. Image: Journal of Nursing Scholarship, 28(3), 241-246.

  5. Buckwalter, K. C., Gerdner, L., Kohout, F., Hall, G. R., Kelly, A., Richards, B., & Sime, M. (1999). A nursing intervention to decrease depression in family caregivers of persons with dementia. Archives of Psychiatric Nursing, 13(2), 80-88.

  6. Kelly, A. W., Buckwalter, K. C., Hall, G., Weaver, A. L., & Butcher, H. K. (2002). The caregivers’ story: Home caregiving for persons with dementia. Home Health Care Management & Practice, 14(2), 99-109.

  7. Stolley, J. M., Reed, D., & Buckwalter, K. C. (2002). Caregiving appraisal and interventions based on the progressively lowered stress threshold model.  American Journal of Alzheimer’s Disease and Other Dementias, 17(2), 110-120.

  8. Garand, L., Buckwalter, K. C., Lubaroff, D. M., Tripp-Reimer, T., Frantz, R. A., & Ansley, T. N. (2002). A pilot study of immune and mood outcomes of a community-based intervention for dementia caregivers: The PLST intervention.  Archives of Psychiatric Nursing, 16(4), 156-167.

  9. Gerdner, L. A., Buckwalter, K. C., & Reed, D. (2002). Impact of a psychoeducational intervention on caregiver response to behavioral problems. Nursing Research, 51(6), 363-374

  10. Smith, M., Gerdner, L. A., Hall, G. R., & Buckwalter, K. C. (2004). History, development, and future of the progressively lowered stress threshold: A conceptual model for dementia care. Journal of the American Geriatrics Society, 52(10):1755-1760.

  11. Gerdner, L. A., Buckwalter, K. C., & Hall, G. R. (2005). Temporal patterning of agitation and stressors associated with agitation: Case profiles to illustrate the Progressively Lowered Stress Threshold Model. Journal of the American Psychiatric Nurses Association, 11(4):215-222.

  12. Smith, M., Hall, G. R., Gerdner, L., & Buckwalter, K. C. (2006). Application of the Progressively Lowered Stress Threshold Model across the continuum of care. Nursing Clinics of North America, 41:57-81.

  13. Lindsey, P. L., & Buckwalter, K. C. (2009). Psychotic events in Alzheimer’s Disease: Application of the PLST Model. Journal of Gerontological Nursing, 35(8):20-27.

  14. Gerdner, L. A., & Buckwalter, K. C. (2013). Musical memories: Translating evidence-based gerontological nursing into a children’s picture book. Journal of Gerontological Nursing, 39(1):32-41.

  15. Robinson, K. M., Crawford, T. N., & Buckwalter, K. (2016). Outcomes of a Two-Component, Evidence-Based Intervention on Depression in Dementia Caregivers. Best Practices in Mental Health, 12(2), 25-42.

  16. Burcu, A. S., Özlem,K.,&  Buckwalter, K.C. (2016). Application of the Progressively Lowered Stress Threshold Model with Community-Based Caregivers: A Randomized Controlled Trial. Journal of Gerontological Nursing. 42(7):44-54.

  17. Moon, H., Robinson, K., Buckwalter, K. (2017). Influence of an Evidence Based Psychosocial Intervention on Caregiver Appraisal. International Journal of Gerontology & Geriatric Research. 1(1):21-29.

  18. Robinson, K., Crawford T., Buckwalter, K., & Casey, D. (2018). Outcomes of a Two Component Intervention on Behavioral Symptoms in Persons with Dementia and Symptom Response in their Caregivers. Journal of Applied Gerontology.

Please contact if you have difficulties accessing any of these papers.

Honoring Geri's Legacy


A women with short hair and glasses smiles for the camera.
Dr. Geri Hall, PhD, RN, FAAN

Geri Hall was an exceptional nurse; a master educator and communicator, a keen observer, a skilled clinician and innovator whose accomplishments and contributions to geriatric nursing vastly improved care of older adults, particularly those with dementia. Geri had the unique ability to teach at all levels: to inform full professors as well as the newest Certified Nursing Assistant, in nursing as well as other disciplines, and those practicing in a variety of acute and long-term care settings. Her writings and presentations were internationally acclaimed and she was a much sought-after presenter and consultant.

Early in Geri’s career, she was credited with the ideas that led to the development of tools and resources to inform caregivers about managing dementia with dignity. Dr. Kathleen “Kitty” Buckwalter (71BSN, 76MA), a fellow graduate and faculty emeriti of the College of Nursing, served as her program advisor and chair for both her master’s and doctoral degrees and a mentor to Geri. Together, they created the Progressively Lowered Stress Threshold Model (PLST) designed to educate formal and informal caregivers about the progression of dementia and associated behaviors to help inform plans of care.

“When her work was first coming out, this was at the beginning of the study of dementia. So really, her research was at the forefront of that,” said Kitty. “Her work is still cited and used all over the world and is as relevant today as it was when she developed it.” Kitty goes on to describe the PLST model as one of the few models nationally recognized as an evidence-based model for dementia.

According to Kitty, "I, like so many others,  learned more from Geri than I ever taught her, and was lucky to call her friend and colleague.  Although she will be missed, Geri has left a remarkable and lasting professional legacy." 

Webpage Last Updated 10.17.2023