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‘Planning live’: using a person-centred intervention to reduce admissions to and length of stay in learning disability inpatient facilities
- Authors:
- BARTLE Janet, CROSSLAND Tom, HEWITT Olivia
- Journal article citation:
- British Journal of Learning Disabilities, 44 (4), 2016, pp.277-283.
- Publisher:
- Wiley
Background: Recent government policy has focused on reducing the number of people with a learning disability receiving treatment for challenging behaviour or mental health difficulties in hospitals (including in assessment and treatment units; ATU). People with a learning disability should be supported to remain in their community when receiving support for challenging behaviour or mental health difficulties whenever possible. Methods: This study considered a novel intervention based on person-centred planning practice, which aimed to coordinate a person's support, identify outstanding needs and increase communication. This intervention intended to reduce rates of inpatient admission, and support the person to remain in their community, whilst ensuring their needs are met. This intervention was assessed by considering the number of people admitted to the inpatient services before and after the intervention, the length of inpatient admissions before and after the intervention, and by analysing qualitative feedback from participants in the intervention. Results: ‘Planning Live’ meetings were held for 102 people. Forty-five meetings were held retrospectively following an emergency admission. Following the ‘Planning Live’ meeting, five people had a planned admission and 52 people did not have an inpatient admission. The median length of inpatient stay fell from 143.5 days before the introduction of ‘Planning Live’ to 66 days (a statistically significant reduction). Qualitative feedback shows that the process was largely seen as helpful by professionals, families and individuals taking part in the meetings. Conclusions: The results suggest this person-centred intervention contributed towards a reduction in the amount of time individuals stayed in hospital. However, the total number of hospital admissions rose following the intervention. (Publisher abstract)
Integrated emotion-oriented care for older people with ID: defining and understanding intervention components of a person-centered approach
- Authors:
- THALEN Marloes, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 18(3), 2021, pp.178-186.
- Publisher:
- Wiley
An increase in descriptive evidence regarding person-centered approaches for older people with intellectual disability (ID) is important, due to increased life expectancy and the present lack of sufficiently underpinned interventions. This is especially true of interventions designed to increase well-being and quality of life. A specific Dutch example is the Integrated Emotion-Oriented Care approach. Despite its status as a good practice, its effectiveness has not yet been proved, nor has descriptive evidence been made available. The primary aims of this qualitative study are to identify the intervention components, to provide demonstrative illustrations and to gain an in-depth understanding of the use of these components in the day-to-day support of older people with ID. A content analysis of five key documents was carried out. Five semi-structured interviews were then conducted with early adopters, followed by a concept mapping study with daily users. The final stage in the data collection process was a series of five focus-group interviews with experts and experienced support staff. The five intervention components of Integrated Emotion-Oriented Care for older people with ID have been systematically identified and described in detail in five narrative summaries drawn up in collaboration with early adopters, experts and experienced support staff. This study provides valuable insights that offer descriptive evidence for Integrated Emotion-Oriented Care in the care for older people with ID. Both implications and possible opportunities for future research are discussed. (Edited publisher abstract)
Reducing challenging behaviour of adults with intellectual disabilities in supported accommodation: a cluster randomized controlled trial of setting-wide positive behaviour support
- Authors:
- McGILL Peter, et al
- Journal article citation:
- Research in Developmental Disabilities, 81, 2018, pp.143-154.
- Publisher:
- Elsevier
Background: Improving the quality of social care through the implementation of setting-wide positive behaviour support (SWPBS) may reduce and prevent challenging behaviour. Method: Twenty-four supported accommodation settings were randomized to experimental or control conditions. Settings in both groups had access to individualized PBS either via the organisation’s Behaviour Support Team or from external professionals. Additionally, within the experimental group, social care practice was reviewed and improvement programmes set going. Progress was supported through coaching managers and staff to enhance their performance and draw more effectively on existing resources, and through monthly monitoring over 8–11 months. Quality of support, quality of life and challenging behaviour were measured at baseline and after intervention with challenging behaviour being additionally measured at long-term follow-up 12–18 months later. Results: Following intervention there were significant changes to social care practice and quality of support in the experimental group. Ratings of challenging behaviour declined significantly more in the experimental group and the difference between groups was maintained at follow-up. There was no significant difference between the groups in measurement of quality of life. Staff, family members and professionals evaluated the intervention and its outcomes positively. Conclusions: Some challenging behaviour in social care settings may be prevented by SWPBS that improves the quality of support provided to individuals. (Edited publisher abstract)
Improving the quality of Positive Behavioural Support (PBS): the standards for training
- Author:
- PBS ACADEMY
- Publisher:
- PBS Academy
- Publication year:
- 2017
- Pagination:
- 17
These standards have been designed to guide practice and training in Positive Behavioural Support (PBS), an evidence based and ethical way of supporting people with learning disabilities who are at risk of behaviour that challenges. The standards will be relevant for those involved in the delivery, purchase, or commissioning of training. This includes external training providers, in-house training teams, and for the recipients of training. The standards cover seven areas: Training course development and content; Personnel delivering training; Resources and facilities; Delivery of training; Assessment; Evaluation; and Record keeping. (Edited publisher abstract)
The first use of dementia care mapping in the care for older people with intellectual disability: a process analysis according to the RE-AIM framework
- Authors:
- SHAAP Feija D., et al
- Journal article citation:
- Aging and Mental Health, 22(7), 2018, pp.912-919.
- Publisher:
- Taylor and Francis
Introduction: The ageing of the population with intellectual disability (ID), with associated conseqences as dementia, creates a need for evidence-based methods to support staff. Dementia Care Mapping (DCM) is perceived to be valuable in dementia care and promising in ID-care. The aim of this study was to evaluate the process of the first use of DCM in ID-care. Methods: DCM was used among older people with ID and care-staff in 12 group homes of six organisations. The researchers obtained data on the first use of DCM in ID-care via focus-group discussions and face-to-face interviews with: care-staff (N = 24), managers (N = 10), behavioural specialists (N = 7), DCM-ID mappers (N = 12), and DCM-trainers (N = 2). The research used the RE-AIM framework for a thematic process-analysis. Results: All available staff (94%) participated in DCM (reach). Regarding its efficacy, staff considered DCM valuable; it provided them new knowledge and skills. Participants intended to adopt DCM, by continuing and expanding its use in their organisations. DCM was implemented as intended, and strictly monitored and supported by DCM-trainers. As for maintenance, DCM was further tailored to ID-care and a version for individual ID-care settings was developed, both as standards for international use. To sustain the use of DCM in ID-care, a multidisciplinary, interorganisational learning network was established. Conclusion: DCM tailored to ID-care proved to be an appropriate and valuable method to support staff in their work with ageing clients, and it allows for further implementation. This is a first step to obtain an evidence-based method in ID-care for older clients. (Edited publisher abstract)
Impact of dementia-derived nonpharmacological intervention procedures on cognition and behavior in older adults with intellectual disabilities: a 3-year follow-up study
- Authors:
- DE VREESE Luc P., et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 9(2), June 2012, pp.92-102.
- Publisher:
- Wiley
Some adults with intellectual disabilities (ID), in particular those with Down syndrome, are at increased risk of dementia. The aim of this study was to investigate the efficacy of specialised environmental and psychosocial interventions in delaying onset of dementia or in slowing down its rate of progression in this population. Specifically, the paper presents the preliminary results of an ongoing prospective study, called the DAD (Down Alzheimer Dementia) Project, carried out in Trento Italy. The study participants were a sample of 14 adults with worsening cognition and everyday functioning who were no longer manageable by their family or staff in day centres or group homes, and who were relocated in a model special care unit (SCU) designed to proactively accommodate the needs of people with ID and dementia. Baseline level and rate of decline across a 3-year period were assessed by means of the Dementia Questionnaire for Persons with Intellectual Disabilities and compared to 2 control groups not in dementia-capable programmes matched for age, sex, and severity of ID. After 3 years, the findings showed some improvement in cognition and stabilisation in everyday functioning and behaviours in the SCU residents and a worsening in the control groups. The findings confirm the validity of this ‘in-place progression’ model and provide a platform for continuing progress in person-centred services and care for aging persons with ID.
Better health and care for all: health and care services for people with learning disabilities
- Authors:
- NIHR DISSEMINATION CENTRE, WALLACE Louise M., CLARKE-HARRIS Rebecca, LAMONT Tara
- Publisher:
- National Institute for Health Research
- Publication year:
- 2020
- Pagination:
- 53
- Place of publication:
- London
This thematic research review brings together NIHR-funded research on health and social care services for people with learning disabilities and their families. It features 23 recent studies and includes summaries of findings. The review covers the themes: understanding learning disability and services; identifying health risks; keeping well in the community; staying well and safe in hospital and preventing avoidable deaths; services supporting positive behaviour; and conducting research together. It also highlights studies that show examples of good practice in involving people with lived experience of learning disabilities in doing research. It also includes the views of people with lived experience around the issues covered by the research. The research finds that more work is needed to improve care for people with learning disabilities, who experience poorer health and die earlier than the general population. Many of these deaths could be prevented by public health interventions or better access to high quality care. It includes important findings for those who commission, deliver, work in and use these services. (Edited publisher abstract)
Arranging and paying for training in positive behavioural support
- Authors:
- SKILLS FOR CARE, SKILLS FOR HEALTH
- Publisher:
- Skills for Care
- Publication year:
- 2019
- Pagination:
- 23
- Place of publication:
- Leeds
A guide for people involved in designing, delivering or commissioning positive behavioural support (PBS) training in adult social care organisations. The guide explains what staff need to know to deliver high-quality positive behavioural support, outlines standards for PBS training and provides advice about commissioning or designing training. It includes links to key organisations. (Edited publisher abstract)
Positive behavioural support: competency framework
- Author:
- PBS ACADEMY
- Publisher:
- PBS Academy
- Publication year:
- 2015
- Pagination:
- 72
This framework provides details of all the things that need to be known and done to provide best practice in Positive Behavioural Support to people with learning disabilities and behaviours that challenge. The Framework is divided into three main areas, which detail the competencies that need to be achieved to deliver effective support. These areas are: creating high quality care and support environments - which aims to ensure that organisations and those providing individual support operate from a person-centred foundation; Functional, contextual and skills based assessment - aims to ensure that the support for each person is based on a thorough understanding of that person’s needs, preferences, abilities and communication style; and Developing and implementing a Behaviour Support Plan (BSP) - aims to provide a detailed and personalised description of how best to support each person with developmental disabilities and their behaviours of concern. The framework will be useful for individuals and organisations providing or procuring direct support or working with people with intellectual disabilities and behaviours that challenge, as well as any health, education or social care professional or service provider responsible for the provision of services. (Edited publisher abstract)
Improving the quality of Positive Behavioural Support (PBS): the standards for service providers and teams
- Author:
- PBS ACADEMY
- Publisher:
- PBS Academy
- Publication year:
- 2017
- Pagination:
- 39
- Edition:
- Beta version 1.1
These standards have been developed for service providers and teams using Positive Behavioural Support (PBS), an evidence based and ethical way of supporting people with learning disabilities who are at risk of behaviour that challenges. It provides standards and criteria covering five areas: the experience of the person, including children and young people, and those involved in their lives; Assessment; Intervention; Facilities, resources, and workforce; and Keeping all people safe using the least restrictive practice and maximising quality of life. The standards are relevant for all services irrespective of size or ownership and are designed for individual service settings, rather than whole service provider organisations. However, some standards do refer to the policies or practices of the larger service provider organisations within the context of supporting the individual service setting in its implementation of PBS. (Edited publisher abstract)