Case study 3 Naomi uses a wheelchair and has autism. Her behaviours of concern a
ID: 127916 • Letter: C
Question
Case study 3
Naomi uses a wheelchair and has autism. Her behaviours of concern are that she hits and bites staff when she becomes agitated in the evenings. At this stage, one of the interventions used has been to try and ask Naomi to count her breaths. This only makes Naomi more agitated. One intervention that has been successful has been to run Naomi a warm bath. When Naomi’s behaviour has significantly escalated, however, some support workers have wheeled Naomi to her room and locked the door. This usually worsens her behaviour. Eventually she calms down and falls asleep. Maahir, one of Naomi’s support workers, is concerned about this practice as it does not seem right and is not detailed in Naomi’s support plan. He talks to his supervisor about the practice, and his supervisor agrees that this is against regulations. The next day, Naomi is wheeled to her room, and her door is locked. While in her room, Naomi bangs her head badly. She becomes quiet. When Maahir checks on her, he sees she is unconscious.
Describe two appropriate intervention strategies Maahir could initiate to address Naomi’s behaviours of concern.
Explain which intervention strategies are inappropriate in Naomi’s situation.
Why is it important for Maahir to interpret and follow Naomi’s behavioural support strategies when they are updated?
How could Maahir ensure that intervention strategies are in line with Naomi’s individualised behaviour support plan?
How should Maahir respond when Naomi is found unconscious?
Describe how Maahir can ensure the safety of Naomi, himself and other people in general, during the critical incident with Naomi.
How could Maahir consult with his supervisor to monitor behavioural support strategies and report on changes in Naomi’s needs and behaviours?
Describe two procedures Maahir must follow in making referrals for Naomi.
Explanation / Answer
Describe two appropriate intervention strategies Maahir could initiate to address Naomi’s behaviours of concern
1.A thorough check in the environment condition and surroundings and a physical examination with the help of a female worker to figure out the trigger for her agitation as because she is getting agitated in the evenings and warm bath is helping her. Check for insects, mosquitos that may be causing irritation on her skin.
If required give a Dermatology consultation.
2. take help of a counsellor or health worker, who can communicate with her and understand her concern
Explain which intervention strategies are inappropriate in Naomi’s situation?
1. Leaving her locked in the room unattended - Locking her in the room can only increase her irritation and agitation may be because of her concern is not answered and maybe she feels like violating her right. Her feelings come out by hitting the wall more worst by hurting herself. She may feel she is abandoned. So it is not at all a solution to lock her up unattended.
2. Giving her advice and instruction when she is agitated - As she is having autism she may be having difficulty in understanding and following instructions/commands. this makes her more irritated and violent. Also being sensitive to sound, it may be very for her to concentrate the instruction
Why is it important for Maahir to interpret and follow Naomi’s behavioural support strategies when they are updated?
It is important to know if she is treated equally as another human as a patient right. She is an autism patient and immobile, and she is having a hard time in communicating her need or requirements with the supporting staff. Being her a support, he needs to check and ensure that Naomi is not violated and is treated with compassion meeting her need.
How could Maahir ensure that intervention strategies are in line with Naomi’s individualised behaviour support plan?
Maahir can build a comfort rapport with Naomi. Give time and space to her to trust him. Encourage her to express her feeling. He can take the help of a psychotherapist, counsellor or a social worker.
Read the gestures and Non-verbal communication.
Do a daily check on the chart to ensure the care has been followed.
Encourage her to speak about her day. Check her chart to ensure her care is given and vitals are marked.
Check her appearance, grooming, physical examination for any redness or marks
How should Maahir respond when Naomi is found unconscious?
An immediate call for medical help. Meanwhile, check the vitals and look for head injury or concussion.Follow ABC...Airway, Breathing, Circulation. Look cyanosis
Describe how Maahir can ensure the safety of Naomi, himself and other people in general, during the critical incident with Naomi?
Inform her family members and get a concent for restraint. Can also opt for sedation with the clear written concept and perception from the treating doctor.