Behavioural Management

 
When people suffer from Traumatic Brain Injury (TBI), such as a road traffic accident or have progressive conditions such as Dementia or Huntingdon’s Disease their behaviours can change for a variety of reasons causing significant distress to their families, their carers and the patient themselves.
 
Specific Examples:
Changes to the brain can cause patients to become more impulsive and do things without thinking e.g. say things which can come across as being rude.  Their emotions can change very quickly and they lose their temper easily. This could possibly be a condition called ‘Episodic Dyscontrol’.  When TBI patients display verbal aggression, e.g. shouting; physical aggression e.g. hitting out with their fists, it can be very distressing for family members, carers and the patient themselves.
 
In patients with progressive conditions they are gradually losing control of their abilities which causes them a great deal of frustration and anger ‘Why me’! They can misunderstand situations when carers try to help them dress where they may see this as an infringement of their personal space.    This can lead to a range of behaviours including poor co-operation and/or compliance with interventions, verbal aggression i.e. shouting, low levels of motivation/drive and disorders of mood e.g. depression.
 
Patients can also display challenging behaviours due to their emotional or even mental health difficulties i.e. depression or psychosis.
 
Careful development of Badby Park has ensured a range of professionals are in place to manage and support residents exhibiting these behaviours including:
Consultant Neuro-psychologist, Consultant Psychiatrist, Consultant of Rehabilitation Medicine, Nurses and Health Care Assistants, Speech and Language Therapist, Occupational Therapists, Physiotherapist, Specialist Assistant Psychologist and Therapy Assistants.
 
Interventions:
  • All the staff members at Badby Park have training in ‘Managing Challenging Behaviours’ and ‘Break Away Techniques’ as part of their induction.   They are also trained in ‘Behavioural Modification Techniques’ and to record inappropriate behaviours.    We do not restrain patients. 
  • At Badby Park we have our own specially designed Antecedent Behaviour and Consequence, (‘ABC’), recording sheets and we use special daily recording sheets called the ‘RAABIT’, (Recording, Arousal, Agitation, Behaviour, Intensively Today)  to monitor positive and inappropriate behaviours.  
  • We also have a ‘Behavioural Pathway’ where more standardised behavioural recordings e.g. the ‘Agitated Behavioural Rating Scale’ are completed by the Neuro-psychology team.
  • Specific behavioural guidelines and behavioural programmes are written for the team to follow.  These are supplemented with specific training given to staff to support them working with certain residents. ‘Anger Management’ training is available for residents.
  • We try and increase the communication and feeling of control for residents whose cognitive and physical abilities are declining.
  • We undertake insight and awareness training to help residents have a clearer understanding of their own difficulties and ways to manage them more constructively.
  • Our Psychiatrist is available to review medications to help improve inappropriate behaviours and mental state.
  • The team is trained to use a variety of therapies such as ‘Cognitive Behavioural Therapy’ and ‘Commitment and Adjustment Therapy’.
  • We have Speech and Language Therapists who can implement supportive communication systems to help residents communicate.   
 
At Badby Park we also provide a range of complementary therapies and interactive activities to also help residents relax and improve their mood and personal wellbeing.