Behavior Management Response Team
The Behavior Management Response Team assists Skilled Nursing and Assisted Living Facilities in the management of acute delirium and dementia based behaviors. The Behavior Management Response Team’s primary purpose is to assess resident and facility needs, to provide assistance with immediate crisis intervention and conflict resolution, and to provide training and support to assist the facility to effectively implement behavior management strategies. The operating philosophy of the Behavior Management Response Team is that most (if not all) delirium and dementia based behaviors have an underlying “cause”, and that resident behaviors are often the resident’s attempt to communicate an unmet need, fear or undiagnosed/under-treated medical condition. The challenge for the care provider then, is to understand the language of the dementia/delirium based behavior”, and to meet the need prior to the behavior occurring.
How the Behavior Management Response Team provides support: When a facility identifies a real or potential behavior management situation in which a resident’s behavior may result in harm to self or others, the Behavior Management Response Team is contacted by the facility Administrator and/or the Director of Nursing. Once initial contact has been made, a member of the Behavior Management Response Team requests (HIPPA compliant) transmission of specific information and may coordinate a facility visit. This enables the Team memeber to:
a) Assess the specific needs of the resident and the facility.
b) Provide immdiate crisis intervention and conflict resolution.
c) Assess staff, situational and environmental factors that may be causally related to the resident(s) behavior.
d) Assess staff knowledge and abilities related to effective behavior management.
e) Assess the appropriateness and utility of existing behavior management protocols and systems.
f) Provide training and support to assist the facility to effectively implement behavior management strategies.
Specific areas of attention may include:
Comprehensive Resident Assessment: Resident Assessment evaluates those residents who present with behavior based issues, as well as those residents whose behaviors have the potential to require specific behavior management strategies. Resident assessment includes a review of the resident’s medical condition and medication review, as well as an assessment of the physical, cognitive and psycho-social needs of the resident which may be causally related to the behaviors.
Crisis Intervention and Conflict Resolution; In response to the need for immediate intervention, the Behavior Management Response Team assists the facility in establishing short-term Care Plans for those residents who present immediate harm to themselves or others. This may include medical assessment and intervention, medication review and revision, staff training, environmental adaptation etc.
Facility Assessment: Facility assessment evaluates the extent to which the facility’s physical environment may be contributing to behavior based issues among residents. Lighting, glare, ambient noise etc. may each be associated with “problematic” behaviors. In addition the facility’s operational procedures may also be examined to determine the extent to which the internal operational systems may contribute to behavior management situations. For example, room relocation, placement of time clocks (for staff to punch time cards), change of shift dynamics, etc. are each operational factors which may be causally related to behavior management issues
Behavior Management Systems Assessment: Behavior management systems assessment examines the specific systems the facility has in place to track behavior based issues, as well as the extent to which the systems are utilized in the resolution or management of behavior based issues.
Staff Assessment: Staff assessment examines the skills and abilities of the facility staff in the identification of antecedent / precipitating factors, as well as staff skills / abilities in addressing behavioral issues.
Staff Training: Staff training encompasses structured staff in-service training to ensure that all staff possess the necessary knowledge, skills and abilities to identify, address and manage behavior based issues among residents.
Monitoring: Monitoring procedures are designed and implemented to ensure that staff utilize behavior management training.
A comprehensive report is developed identifying observations and findings, as well as targeted recommendations.