Tuesday, October 5, 2010

HEY HELP ME HERE!

Diana believes that the key to behavior and falls management lies in the ability to determine the resident's motivation for their actions. Only when healthcare providers understand that motivation and then see their role as assisting the resident to reach their goal will success in reducing challenging behaviors be realized.

As expected, Diana offered many practical and immediately useable tips for behavior management as it relates to quality care for residents in long term care facilities.

Although each recommendation is priceless (just ask Diana!) here are a few that Diana would suggest that you commit to memory:

1. ALL BEHAVIOR IS MOTIVATED.


2. A fall is nothing more than the result of a motivated behavior.


3. Unless and until the staff focus in on "Why they are getting up", managing falls and challenging behaviors will continue to be seen as a failure to staff members.


4. The five hundred pound gorilla in the room is the percentage of residents in a facility with Cognitive Loss. The national average is approximately 80%. There is no diagnosis, syndrome or symptom that affects any where near that many residents. Long term care staff members must become dementia experts if care is to meet the unique needs of this population.

5. Knowing a resident’s cognitive functional age is vital. Two standardized and validated tests are: ALLEN COGNITIVE LEVELS www.allen-cognitive-network.org and RCCT www.clocktestrcct.com. For more information on these tests, please visit these two websites.

6. Freedom from the use of both physical and psychological restraints as devices to manage a resident behavior will occur only when there is a facility policy in place requiring that these devices are not utilized. By having such a policy in place a precident will be set to focus on the resident's need rather than using external devices to change an internal motivation.


7. With the "no devices" policy in place, the staff must determine the resident's motivation for moving and then HELP THEM REACH THEIR GOAL, not to stop them - which has been the practice.



What Would You Do For These Residents?


1. A resident likes to sit on the floor instead of sitting in a chair. She does not have cognitive loss. There is a faction at the facility that believes she should not sit on the floor and have instituted restraining shoulder harnesses to keep her sitting in a chair instead.


Diana suggests let her sit on the floor! Care plan it. Have a Physical Therapist perform an assessment on her ability to get on the floor and then get back up to determine where she will need help. Then outline a plan to help her to meet her goal successfully.

Diana's DVD HEY HELP ME HERE! will provide you with other alternatives.


2. A resident gets very upset when we try to bath her. Currently we have quite a "battle" with her. Not only is it challenging for her, it is very challenging for staff.


Diana suggests several alternatives. Consider rinse-less soap; changing the words you use from "shower" to "bath"; reducing bathing from a total bath to washing body areas that cause odors such as hair and perineum; involving her is an activity where she gets "dirty" such as kneading bread or replanting a plant.


Diana's DVD BATHING MADE EASY can give you additional possible interventions.


Want to ask Diana a specific question? Visit her Contact Us page and ask away!








1 comment:

Thank you for your comment. If it is approved it will be posted to our blog.