Dealing with Challenging Behaviours With Jayne Harvey.
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Transcript of Dealing with Challenging Behaviours With Jayne Harvey.
Dealing with Challenging Behaviours
With Jayne Harvey
The Supportive Therapy Model
Supportive Therapy is a comprehensive behaviour management program
encompassing a full range of functional assessment tools, programming options and care practices developed over 20 years of qualitative research and implementation.
Dementia is the primary focus for this model, however many of the concepts and tools are applicable for other types of clients as well.
The Supportive Therapy: Philosophy
The person is suffering from brain damage.
If what you are doing for this client is not working,
Then change what you are doing
Because the client cannot change.
The Supportive Therapy: Principles
To define the individual’s strengths (what the individual is still capable of doing) and maintain them.
To define the individual’s limitations (what the person can no longer do) and compensate for them.
To define the areas of vulnerability (the stressors the individual cannot tolerate) and intervene.
The Supportive Therapy: Objectives
1. Provide safe & secure environment for wandering client2. Provide consistency in routines and staff3. Establish a philosophy specific to needs of dementia4. Develop specific care process involving ongoing
analysis & assessment of functioning ability.5. Provide specific social & activity programs geared to
cognitive functioning ability6. Train staff in approach, communication, assessment &
understanding to work with those living with dementia 7. Provide mechanism to define individual vulnerability 8. Provide environment adapted to the needs of client
Behavioural Changes.
Why or when does behaviour become challenging?
Frustration
Reality Orientation
Pain
Medication
Challenging competency
Brain Deterioration
Confusion
Fear
Isolation
Boredom
Fast & Easy InterventionsThings to remember: Meaningful & successful interventions aren’t complex Engage client in helping activity of helping ( feel needed) Use & talk about things you like, know & understand Keep it simple, e.g. baking Throw away your desire to be perfect Be flexible & let client lead intervention where they want Be resourceful & have repertoire of interventions Learn & be comfortable with set of open/closed
questions Most questions can be asked in either style. Modify according to client ability KNOW YOUR CLIENT
Fast & Easy Interventions cont.
Closed Ended Questions: yes/no answers
Open Ended Questions: more elaborate answers
Do you like baking?
Are you a good baker?
Did you ever have a baking fiasco?
Did you buy store bought cookies or bake your own?
What do you like about baking?
What are some of your specialties?
Tell me about a time when your baking when wrong?
What types of cookies did you bake?
Sensory Specific Interventions
Visual Clear and bright pictures (stored in a binder
theme sorted) Original and different jewelry or clothing Coffee table books
Auditory Singing Mimicking sounds and voice patterns (tongue
twisters)
Sensory Specific Interventions cont.
Tactile
Material swatches
Tactile apron
Stress balls
Water logs
Olfactory
Essential oils
Nature items (grass, flowers)
Gustatory
Candies
Fruit
Cognitive Specific Interventions
Quickie Quizzes
Using alphabet & topic, find word for every letter
Days of the week
Special days in each month
Spelling bee
Math calculations
Times tables
Adding sums
Activities of Daily Living Interventions
Kitchen Setting tables Washing/drying dishes
Housekeeping Dusting Carpet Sweeping Cleaning windows / glass surfaces Wiping off table tops
Activities of Daily Living Interventions
Laundry Folding Hand washing items
Sorting Socks Winding yarn Costume jewelry Jars and lids Junk drawers/clutter cupboards
Activities of Daily Living Interventions
Clerical work Removing stamps from envelops Opening mail for the boss (save your junk
mail)
Reminiscent Specific Interventions
Reciting Nursery rhymes Poems Saying and slogans
Restraints
Why do we use restraints?
Safety
Prevent interference with medical devices
Reducing staff stress and involvement
Restraints cont.
What types of restraints are there?
Physical restraints: hand mitt, bed restraint, arm restraint, vest restraint
Mechanical restraints: wheelchair tables, wheelchair footrests
Environment restrains; locked doors, Dutch doors
Chemical/pharmacological restraints: drugs
Restraints cont.
What are some of the risks associated with the above restraints?
1.
2.
3.
4.
5.
Restraints cont.
What We Can Do to Avoid Using Restraints Assess client to understand the message
behind the behaviour Brainstorm interventions or strategies List the interventions Try the first intervention (and on down the list
til the appropriate one surfaces Document results Re-assess
FCS International158 Casimir St, Suite 200Port Perry, ON L9L 1B7
Ph 905-985-6811www.fcsinternational.com