Search results for ‘Subject term:"challenging behaviour"’ Sort:
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Research note: identifying individuals with learning disabilities whose behaviour challenges our services
- Authors:
- SPEAKE Brian, et al
- Journal article citation:
- Research Policy and Planning, 9(2), 1991, pp.27-30.
- Publisher:
- Social Services Research Group
Describes the collection of data on individuals relating to their functional abilities and challenging behaviour.
An introduction to residential child care: managing challenging behaviour
- Authors:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE, STANLEY Jonathan, SAINSBURY Mary
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2008
- Place of publication:
- London
This e-learning resource explores how children communicate through their behaviour and covers techniques for managing challenging behaviour. It aims to improve understanding of: the notion of behaviour as communication; how to manage challenging behaviour in a planned way; key issues with regards conflict resolution, diverting and de-escalating challenging situations and restraint; tools and techniques for conflict resolution, diverting and de-escalating challenging situations and restraint; and the key stage of debriefing.
Very frequent physical aggression and vocalizations in nursing home residents with dementia
- Authors:
- VELDWIJK-ROUWENHORST Annelies E., et al
- Journal article citation:
- Aging and Mental Health, 25(8), 2021, pp.1442-1451.
- Publisher:
- Taylor and Francis
Objectives: We investigated the 2-week prevalence and correlates of very frequent physical aggression (PA) and vocalizations in nursing home (NH)-residents with dementia. Method/Design: This cross-sectional study used combined data of 2074 NH-residents from four studies, collected from 119 dementia special care units in 26 Dutch NH. Very frequent PA was defined as scoring 6 or 7 on the items ‘hitting’, pushing’, ‘biting’ and ‘kicking’ of the Cohen Mansfield Agitation Inventory; very frequent vocalizations as scoring 6 or 7 on ‘screaming’ and ‘making strange noises’. We compared NH-residents with very frequent PA or vocalizations with residents with less frequent PA or vocalizations, assessing correlates using univariate and multivariate multilevel logistic regression analyses. Results: We found a 2-week prevalence of 2.2% (95% confidence interval (CI): 1.63–2.89) of very frequent PA and 11.5% of very frequent vocalizations (95% CI: 10.23–12.98). Very frequent PA was only associated with apathy (odds ratio (OR)=1.93, 95% CI: 1.04–3.61). Correlates of very frequent vocalizations were age (OR = 0.97, 95% CI: 0.951–0.998), dementia severity (overall p-value 0.020), antipsychotic drug use (OR = 1.56, 95% CI: 1.08–2.26), antiepileptic drug use (OR = 2.75, 95% CI: 1.34–5.68) and euphoria (OR = 2.01, 95% CI: 1.22–3.31). Conclusion: Characteristics of NH-residents with very frequent PA or very frequent vocalizations differ from those of NH-residents with less frequent PA or vocalizations. Frontal lobe damage, boredom, pain and/or external factors may explain several of the found associations, but further research is necessary. Our findings may contribute to better care for these residents and thereby to improving their quality of life. (Edited publisher abstract)
Challenging behavior of nursing home residents during COVID-19 measures in the Netherlands
- Authors:
- LEONTJEVAS Ruslan, et al
- Journal article citation:
- Aging and Mental Health, 25(7), 2021, pp.1314-1319.
- Publisher:
- Taylor and Francis
Objectives: From the perspective of the nursing home (NH) practitioners, to gain understanding of (1) whether challenging behavior in NH residents changed during the COVID-19 measures, (2) whether the practitioners’ involvement in the treatment of challenging behavior changed, (3) what can be learned from the experience of NH staff. Methods: A mixed methods study with a survey in 323 NH practitioners (psychologists, elderly care physicians, nurse practitioners) in the Netherlands, and in-depth interviews in 16 NH practitioners. Nonparametric analyses were used to compare estimated proportions of residents with increased and with decreased challenging behavior. Content analyses were conducted for open-ended questions and in-depth interviews. Results: Participants reported changes in challenging behavior with slightly higher proportions for increased (Q1/Mdn/Q3: 12.5%, 21.7%, 30.8%) than for decreased (8.7%, 14.8%, 27.8%, Z = –2.35, p = .019) challenging behavior. Half of the participants reported that their work load increased and work satisfaction worsened during the measures. Different strategies were described to respond to the effects of COVID-19 measures, such as video calls, providing special areas for residents to meet their loved ones, adjusting activities, and reducing the exposure to negative news. Conclusions: Because COVID-19 measures resulted in both increased and decreased challenging behavior in NH residents, it is important to monitor for their potential long lasting effects. Increased work load and worsened work satisfaction of the NH staff, together with the changes in type of challenging behavior, indicate that the harmful effects of the anti-pandemic measures should be taken seriously. (Edited publisher abstract)
Factors facilitating or hindering meaningful staff–client interactions in people with intellectual disabilities and challenging behaviour: a systematic mixed studies review using thematic synthesis
- Authors:
- SIMONS M.A.G., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 34(2), 2021, pp.446-458.
- Publisher:
- Wiley
Background: Interactions with professional caregivers affect the quality of support and life of people with intellectual disabilities and contribute to the occurrence of challenging behaviour. The present literature review provides an overview of factors facilitating or hindering meaningful staff–client interactions in people with borderline to profound intellectual disabilities and challenging behaviour. Method: Database searches, reference list and citation screening, and expert consultations were undertaken. A thematic synthesis of 28 studies was performed. Results: Factors were identified at the client (i.e. behaviour, emotions and (dis)abilities), staff (i.e. interactive principles, knowledge, psychological resources, attributions, attitudes and (coping with) emotions) and context levels (i.e. group size, team and organization). Conclusions: The present overview provides insights into factors that facilitate or hinder meaningful staff–client interactions with people with intellectual disabilities and challenging behaviour. The results support the need to combine client, staff and contextual factors when considering staff–client interactions in research and practice. (Edited publisher abstract)
The use of therapeutic untruths by staff supporting people with an intellectual disability who display behaviours that challenge
- Authors:
- MCKENZIE Karen, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 34(1), 2021, pp.28-35.
- Publisher:
- Wiley
Background: Therapeutic untruths (TU) are used in dementia services to de‐escalate distressing situations. The present authors explored the use of TU by care staff supporting people with an intellectual disability who displayed behaviours that challenged. Method: Data were collected from 126 staff (female = 72.2%; mean age = 41.9 years, SD = 10.7) via an online survey in relation to three areas: responses to three scenarios, reported use of different forms of TU and ratings of perceived effectiveness of, and level of comfort using, each type. Results: 96% of participants reported using TU themselves and observing their colleagues doing likewise. Models that included perceived effectiveness of, and level of staff comfort with using, different TU were significant, although only perceived effectiveness significantly independently contributed to the model. Conclusion: The use of TU was common, with levels consistent with those found in dementia services. The limitations and implications of the findings are discussed. (Edited publisher abstract)
Developing a logic model for the Triple‐C intervention: a practice‐derived intervention to support people with intellectual disability and challenging behavior
- Authors:
- TOURNIER Tess, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 17(4), 2020, pp.297-307.
- Publisher:
- Wiley
Partly due to a lack of evidence‐based methods to support people with intellectual disability (ID) and challenging behavior, their needs are often poorly met. One way to generate rapid evidence is to systematically describe and monitor interventions that are considered to be “good practice”—to develop evidence based on practical knowledge. This study describes the Dutch practice‐based intervention Triple‐C (Client, Coach, Competence). The intervention was developed in practice to support people with severe ID to borderline functioning and challenging behavior. The practice‐based nature of Triple‐C means that many of the professionals' actions or activities are often underpinned by their implicit knowledge about the intervention they are delivering. Consequently, as the emphasis is on practice, the professionals can find it difficult to articulate how the intervention is operationalized and positive change achieved. This study aimed to assess the practical knowledge of Triple‐C professionals and to develop an understanding of the mechanisms of change for Triple‐C to improve understanding and to inform future research about the intervention. Through an iterative process, a logic model was developed to describe the intervention and its underlying assumptions. The development of the logic model was shaped using interviews with the founders, focus groups with support staff, psychologists, managers and members of the board of a service provider, and the analysis of published accounts of the Triple‐C intervention. Data gathered from these sources were analyzed using content analysis. The logic model of the Triple‐C intervention provides insight into the key elements of the approach, such as the need for unconditional supportive relationship and carrying out meaningful activities. Moreover, the potential relationship with existing evidence‐based interventions such as Positive Behavioral Support and Active Support are described. Defining the underlying logic of a practice‐based intervention like Triple‐C is an important first step toward producing an evidence base for interventions developed from clinical practice. (Edited publisher abstract)
Wellbeing for life: changed behaviour
- Author:
- MACINTYRE
- Publisher:
- MacIntyre
- Publication year:
- 2018
- Pagination:
- 20
- Place of publication:
- Milton Keynes
A short publication providing information the behaviour changes someone may see in relation to supporting a person with learning disabilities who is living with dementia. It covers common changed behaviours as dementia progresses, understanding that all behaviours are a form of communication, ways to support a person to understand their behaviour and of supporting staff within the workplace. It is part of the Wellbeing for Life toolkit created for the MacIntyre Dementia project in order to promote understanding about getting older with a learning disability and living well with dementia. (Edited publisher abstract)
Coming home: a report on out-of-area placements and delayed discharge for people with learning disabilities and complex needs
- Author:
- MacDONALD Anne
- Publisher:
- Scotland. Scottish Government
- Publication year:
- 2018
- Pagination:
- 71
- Place of publication:
- Edinburgh
This two-year project, commissioned by the Scottish Government, collected national data on people with learning disabilities who have additional complex needs, and who are either placed out-of-area, or are within hospital-based assessment and treatment units, classed as delayed discharge. It aimed to gather information on the issues and suggest support solutions and actions that could improve outcomes for people with learning difficulties who have been unable to receive appropriate support in their communities. The project found that there were 705 people out-of-area in Scotland from 30 HSCPs, Of the group, 79 were placed out of Scotland and 453 were identified as being placed out-of-area not through choice. Challenging behaviour, and the impact that challenging behaviour has on service breakdown or hospital admission was a key issue for people with learning disabilities and complex needs. This was partly due to a lack of coordinated responses. Key elements contributing to good support for people with learning disabilities and complex needs were identified as: person-centred approaches, environments which support communication, active support and full lives, positive behavioural support, suitable accommodation, skilled and motivated staff, and good management and practice leadership. The report makes recommendations for Integrated Health Authorities, Health and Social Care Partnerships and the Scottish Government. It calls for a transformational change approach, with all stakeholders working together to address the issue. (Edited publisher abstract)
Positive and proactive care: reducing the need for restrictive interventions: summary of key actions
- Author:
- GREAT BRITAIN. Department of Health
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2014
- Pagination:
- 4
- Place of publication:
- London
A summary of good practice guidance which identifies key actions that will better meet people’s needs and enhance their quality of life, reducing the need for restrictive interventions. It also sets out mechanisms to ensure accountability for making these improvements, including effective governance, transparency and monitoring. Relevant for all those working in health and social care settings: commissioners of services, executive directors, frontline staff and all those who care for and support people known to be at risk of being exposed to restrictive interventions. (Edited publisher abstract)