Planning Support for Persons with At-Risk Behaviors in the Community
Setting
Jacquelyn Solomon, M.S. LPA
Purpose of Training
• Addressing At-Risk Behaviors and Planning for Everyone’s Safety
– Assessing the elements of an effective understanding of the level of supervision and support that a person with a brain injury may need when transitioning into the community.
Agenda
• At-Risk Behaviors–What do they look like? – Examples
• How to Assess and Address– Discuss assessments for each at-risk
behavior– How do we address these issues?
• Resources
At-Risk Behaviors
• Substance Abuse History– Alcohol– Other drugs
• Premorbid use• Post-injury use• Previous treatment?• Triggers– Less in residential facility
At-Risk Behaviors
• Mental Health Issues– Premorbid– Post-injury
• Personality Changes– Behavioral Issues due to changes?• How will this affect their transition to
community?
• Impulsivity• Social Interaction – Appropriate?
At-Risk Behaviors
• Medication Management– Take medication appropriately?• Time• Amount• Dosage
• Memory can affect this greatly• Missing doses or taking too much can
have serious side effects
At-Risk Behaviors
• Hygiene– Showering– Oral care
• Sequencing• Initiation• Lack of proper hygiene can have
serious side effects with time
At-Risk Behaviors
• Household Tasks– Laundry– Cooking– Organization• Safety
– Ex: Know where the fire extinguisher is?– Fall Risks
• Misplaced items
– Nutrition
At-Risk Behaviors
• Community–Where is the residence?– Is it a safe environment?–What needs to be known about the
area?
Assess and Address
• Substance Abuse History– Assess• History• Counseling
– Address• Support system when in community• Attend meetings • Continued treatment
– Resources• AA/NA• Counseling Services
Assess and Address
• Mental Health Issues– Assess• History• Counseling
– Address• Continue providing counseling services• Educate on coping mechanisms• Educate support system
Assess and Address
• Memory– Assess• While at our facility, Speech and OT assess
memory throughout length of stay
– Address• Memory strategies:
– Taking notes; keeping track in a planner or tablet– Visual cues
• Educate family members and support system
Assess and Address
• Medication Management– Assess• Know medication?
– Dosage, Time, Amount
– Address• Work on becoming independent with
medication while still in treatment facility• Have companion/family member organize
medication in pill organizers for them once out in community
Assess and Address
• Hygiene– Assess• OT assesses at residence while in treatment
and determines what level of assistance pt needs• Assessment continues throughout treatment
– Address• While in treatment, OT works with pt to
increase their level of independence• If still needs assistance when transitioning
into community (i.e. with family member) educate the family members who pt will be living with
Assess and Address
• Household Tasks– Laundry– Cooking– Organization• Safety• Misplaced items
– Nutrition
Assess and Address
• Transportation– Assess• Does participant have access to
transportation?• Do they know how to safely utilize public
transportation?
– Address• Work with them while still at facility
– Make schedule; call for rides
• Educate family members/support system
Assess and Address
• Risk of Exploitation– Assess• Give scenarios• Look at history
– Address• Provide education• Make reminder cards for participant• Work with them to put them on a no contact
list
Assess and Address
• Community– Assess• Therapist will assess the surroundings of the
residence participant is moving to
– Address• After assessment, discuss and teach
participant about surrounding area
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