BEHAVIOR TOOLS
BEHAVIOR TOOLS If you learn to listen for clues as to how I feel instead of what I say, you will be able to understand me much better. -Mara Botonis
BEHAVIOR TOOLS Identify What was the behavior? Was it harmful? What is the cause and/or trigger? Unmet needs or distress: Look beyond the emotional distress When and where did it occur? What happened prior to the behavior? Were there any other people involved? Are there any patterns (e.g., certain time, day, medications, family visits, shift change)? ü How is the resident communicating through body language, words and emotions? ü What are the physical, environmental and emotional triggers? ü ü ü ü ü ü ü ü
BEHAVIOR TOOLS Environmental Triggers o Too much noise o Intrusion into personal space o Temperature too hot or cold o Lack of privacy o New environment or people added o Something familiar removed
o Too bright or too dark o Smells o Full moon or sun setting o Shift change o Something unfamiliar o Other:
BEHAVIOR TOOLS Physical Triggers o Symptom of disease o Infection (UTI) o Pain/recent injury o Medication side effects o Dehydration o Other:
o Hunger or thirst o Fatigue o Incontinence o Constipation o Unmet physical need
BEHAVIOR TOOLS Emotional Triggers o Change in routine o Recent changes or losses o Difficulty with family, friends, staff o Need to regain a sense of control o Depression o Emotional state of other people
o Boredom o Past or current events o Anxiety o Fear o Loneliness o Lack of intimacy o Other:
BEHAVIOR TOOLS
Use your voice for kindness, your ears for compassion, your hands for charity, your mind for truth and your HEART for love.
BEHAVIOR TOOLS Adapt Look for ways to adapt to the resident and their routine • Changing when or how the resident receives care • Breaking tasks down into smaller steps • Allowing the resident more time to do each step • Doing tasks at different times • Doing more prompting and cueing • Encouraging independence and choice • Using assistive devices to their fullest extent o Other:
BEHAVIOR TOOLS
Remember: Your resident is not GIVING you a HARD time; your resident is HAVING a HARD time.
BEHAVIOR TOOLS How to Respond o Constantly be aware of signals the resident is giving off o Be ready to adapt, walk away, soothe, distract or redirect o Be willing to do something different o Minimize or eliminate the trigger(s) o Did it hurt anyone? o Other:
BEHAVIOR TOOLS Refrain From • • • • • Other:
Orienting to reality Correcting behavior Ignoring the behavior Arguing with the resident Attempting to use reasoning to change the behavior
BEHAVIOR TOOLS Who Is Your Resident? o How do you know when the resident likes or dislikes something? o What types of things, situations or people seem to make the resident frustrated, anxious, nervous or angry? o What pace of activity is comfortable for the resident? Too fast or too slow o How does the resident communicate (both verbally and with body language)? o Review their embrace history for likes, dislikes, typical routine, culture o Other:
BEHAVIOR TOOLS Internal Huddle Community to take team approach – ED, HWD, MCD, MCC, care partners to discuss behaviors and what interventions to put into place
• • • • • • •
Who was involved? What happened? When did it occur? Where did it occur? Why? Update the Service Plan or put a Temporary Service Plan in place Monitor
BEHAVIOR TOOLS Intervention Ideas & Examples Update the Bradford Wellbeing Rule out any acute medical changes Resident engaged or lack thereof Staff Training (approach, communication, etc.) Program o Create a Personalized Snapshot Kit o Other: o o o o
o Start Behavior Logs o Assess for pain o Start a Survey of Discomfort (SDD) Form o Enroll resident in an Essence Session o Create a personalized music playlist - use noise cancelling headphones o Create a “My Page� on the IN2L system
BEHAVIOR TOOLS External Huddles When to initiate? After internal huddle and/or after any atypical behavior How? Reach out to DDHW, DDMCP, RDO, VP of Res. Experience and/or VP of Clinical to request a Behavior Huddle Who? ED, HWD, MCD, MCC, Care Staff & Regional Support Teams Be prepared with: Chart, Behavior Log, Medication, Weights & Vitals, embrace history Follow-up: Community will send follow-up email with interventions put into place and if interventions were successful. If not, schedule another huddle. Update: Service Plan, Riskonnect (adding interventions)
BEHAVIOR TOOLS
Persons living with dementia are usually capable of more than we can imagine. -Bob DeMarco
BEHAVIOR TOOLS Questions Cathleen O’Brien, Vice President of Resident Experience 331-645-1169 cobrien@seniorlifestyle.com Brittany Coleman, Divisional Director of Memory Care & Programming bcoleman@seniorlifestyle.com 224-587-9930 Amber Dahle, Divisional Director of Memory Care & Programming adahle@seniorlifestyle.com 312-371-2102 Fran McMullen, Divisional Director of Memory Care & Programming frmcmullen@seniorlifestyle.com 585-409-0421
BEHAVIOR TOOLS Resources This Behavior Tool was developed from feedback and input gathered from: • •
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Aging and Long-Term Support Administration Senior Lifestyle Corporation Memory Care Directors, Divisional Directors of Memory Care and Programming, Divisional Directors of Clinical, Regional Directors of Operations and Vice President of Resident Experience Washington State Dept. of Social Health Services DSHS - Navigating through challenging behaviors Teepa Snow - Challenging Behaviors
A huge shout-out and thank-you to Kim Koppert for pulling together this tool. Thank you, Kim!