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JCPSLP
Volume 19, Number 2 2017
Journal of Clinical Practice in Speech-Language Pathology
unit! On-the-job training, however, is one of the best ways
to learn. Over time confidence working with patients who
have BOC will build. Standard staff training programs for
aggressive and violent behaviour from patients or family
members is good to attend, but the techniques utilised in
these programs may not always be suitable for a patient
with an ABI. An individualised behaviour management plan,
contributed to by the team, is likely to be a superior
resource.
10 Trial and error is a way of building
builds resources for the service
Over time an ABI team that works together in challenging
and rewarding ways develops resources that evolve as a
process of trial and error. The behaviour management plan
process in the ABI Unit at Caulfield hospital is a
sophisticated and effective process which has evolved
since the unit opened and has a tangible impact on
reducing behaviours of concern and the incidence of Code
Greys in the unit. An evening service trialled as a way of
alleviating boredom and BOC for a group of patients in the
low stimulus area was effective in reducing BOC during the
afternoons and evenings for the period it ran. Another
initiative trialled was the introduction of an exercise program
in the low stimulus area, for patients who were unable to
access the gym because of BOC.
activities during and after hours (e.g., birthday BBQ, footy
celebrations, enjoyable communal activities such as
cooking) can assist patients who have behaviours of
concern to feel more settled and less confused. An
enriched environment working party can be a way of
coordinating ideas and rostering a range of tasks.
8 The family as a resource
Not all patients have supportive families; however, many do.
It can be distressing for families to see their loved one in a
highly confused state; sometimes they are the only person
who can settle a patient down. The family can also be a
rich resource for information about what the person likes
and does not like, what music they enjoy, if there is a
television program they like, or a food they might prefer.
Families will often be willing to help support behaviours of
concern by being a part of the behaviour management plan
(e.g., “If Paul is beginning to pace up and down the corridor
he may be settled by calling his mother”).
9 Accessing formal and informal training
Organisations that employ staff who work with patients with
BOC usually provide extensive on-the-job training, as well
as formal, general training which might be available via
electronic learning systems. This is not training you put on
your “to do” list if you are going to be working in an ABI