27th September 2024

Understanding Behaviour Support Planning

Clinical

Author

Anchor Excellence

September is Dementia Awareness Month—a time dedicated to raising awareness and understanding about dementia, a condition that affects millions of people worldwide. One critical aspect of dementia care is Behaviour Support Planning (BSP), which plays a vital role in enhancing the quality of life for individuals living with dementia.

Mood Changes and Dementia: What You Need to Know

Dementia can significantly alter how an older person feels and behaves. These changes may be subtle or dramatic, transient or persistent, and often lead to actions that are out of character for the individual. Such shifts are not intentional but can be distressing for both the older person with dementia and their loved ones.

Several factors contribute to these behavioural changes:

  • Physical changes in the brain caused by dementia.
  • Communication difficulties due to cognitive decline.
  • Environmental changes, such as variations in temperature, noise levels, or lighting.
  • Altered abilities like vision, hearing, or thinking capacity.
  • Health issues, including medication side effects or underlying illnesses.
  • Physical discomforts, such as hunger, tiredness, dehydration, or the need to use the toilet.
  • Unmet emotional or physical needs.

Common mood and behaviour changes in dementia include disinhibition, agitation and aggression, sleep disturbances, delirium, hallucinations and delusions, shadowing (following someone around constantly), wandering away from home, depression, restlessness in the afternoon (sundowning), and anxiety.

The Importance of Behaviour Support Plans

As per amendments to the Aged Care Act 1997 and Quality of Care Principles 2014 effective from September 1st 2021, residential aged care and home care providers must have a BSP for each older person requiring restrictive practices. The primary goal is to reduce and potentially eliminate restrictive practices while improving care provision and quality of life.

A well-crafted BSP should:

  1. Be individualised and current.
  2. Include comprehensive assessments on behaviours.
  3. Identify triggers or causes preceding those behaviours.
  4. Outline alternative strategies known to manage those behaviours effectively.
  5. Detail any restrictive practices used only after alternative strategies have been tried.

Developing Effective BSPs: Best Practices

Creating an effective BSP involves understanding the individual’s unique circumstances:

  1. Information Gathering: Collect data from various sources including family members, friends, previous caregivers, and the older person’s current healthcare professionals focusing on:
  • Personality traits
  • Key relationships
  • Education and occupation history
  • Cultural background
  • Likes/dislikes
  • The older person’s goals, needs, and preferences
  • Religious beliefs
  • Interests/hobbies
  1. Understanding Behaviours: Document how behaviours manifest over time—what triggers them? Are there unmet needs like hunger or pain? What usually calms the older person?
  2. Assess Risks: Evaluate if sudden behavioural changes indicate medical issues like delirium; assess potential harm risks; consider specific risks tied to any restrictive practices used, have other assessments or interventions been used in the past?
  3. Management Options: Engage with the individual about what might help; consult family/friends; try documented strategies while avoiding past failures; involve all workers for ideas/observations; seek professional advice from a registered behaviour support practitioner when needed.

Tips for Minimising Behavioural Changes

To minimise behavioural fluctuations:

  • Provide a calm environment with familiar settings/routines.
  • Avoid correcting untrue statements; stay neutral instead.
  • Allow ample time for communication/daily activities without rushing them.
  • Refrain from punishment as they may not remember events causing distress nor learn from it subsequently.
  • Stay calm yourself—your composure helps theirs too!
  • Use slow speech delivered reassuringly during conversations/activities enjoyed by them.

Taking Care of Yourself

Caring for someone with dementia can be challenging—remember it’s okay (and necessary) to look after your own health/happiness too! If you’re struggling emotionally/physically while caregiving duties mount up around you then reach out via National Dementia Helpline at 1800 100 500 anytime day/night—it’s free/confidential offering information/support/advice tailored specifically towards helping workers navigate through challenging periods ahead together successfully!

For those interested in further education on this topic—including practical approaches towards managing Restrictive Practices & Behaviour Support Plans—we offer courses via Anchor Academy accessible here.

Join us this Dementia Awareness Month by learning more about behaviour support planning—helping to improve the lives and lived experiences of older Australians, not just today but also for a better tomorrow!

Reference:

Department of Health and Aged Care: Behaviour Support Plans – Fact Sheet

Dementia Australia