When I was a younger professional, and just after receiving my Master’s Degree, I took a position as a therapist in a group home for seriously mentally ill, criminal adolescents. Some had very violent histories, including attempts to murder their parents. Although I had little to no experience in this area, I thought, “What the heck! I got this!”
Upon entering the building for the first time, dressed in khakis, penny loafers (with pennies in them), navy blue blazer with gold buttons and briefcase in hand, I was told that I had better start wearing tennis shoes to work. When I asked why, a team member said “Because you can run for your life faster!”
(NOTE: Interested in learning more about Behavioral and Mental Health? Checkout my Behavioral and Mental Health CEUs on CEU Academy and try a FREE CEU today!)
Two weeks later, I was working in nursing homes! Surely, I thought that these places would be much safer and there’s no way that elderly residents would attack, yell, throw objects or harm me in any way. I was wrong and thirty years later, I have many tales to tell about violence in senior care.
De-Escalation Training Is a Must
I tell this story to highlight the importance of employees in senior care to receive as much training in crisis management, treat assessment or de-escalation as possible. Beyond all of the other areas you need to be effective in, such as clinical care, quality of life, nutrition, and leadership, you need to be prepared for anything to happen in senior care, even physical violence.
What is De-Escalation?
De-escalation is the first line of response when dealing with violence or potential violence in a health care setting. According to the CDC, nurses and nursing assistants are the prime target for violence and some studies indicate that up to 25% of nurses say they have been assaulted by either patients or their family members.
De-escalation is much like conflict resolution, conflict management, crisis resolution or diffusion. It is a group of strategies, interventions, and techniques that are used to reduce the resident’s anger, frustration or violence. De-escalation includes communication, self-regulation, continual assessment, taking appropriate actions and safety considerations. The goal is to reduce the risk of harm to residents, families and caregivers.
Benefits of de-escalation include prevention of violent behavior, avoiding the use of restraints, either physical or chemical, reducing anger and frustration for all involved, and maintaining safety.
De-Escalation Tips
In order to use de-escalation effectively, you need to know as much about it as possible. You should also have confidence in your skills to talk someone down in a controlled and appropriate manner. Always start your intervention by being empathetic with the resident. No one wants to really become violent and cause a commotion. But, they may no longer be in control of their behaviors, cognition or emotions due to certain diseases or side-effects of medications.
Respect their personal space and do not invade it. Use your words in non-threatening ways and do not overreact to any response from the resident, because this can escalate the situation. Stay calm. Focus on the resident’s words and their emotions. Ignore any challenges posed by the resident and set some appropriate limits to their behavior. You want them to vent, but it’s not a free-for-all. Use silence as an opportunity to calm things down. No one needs to say or do anything sometimes. In other words, no intervention is the best intervention.
Final Words on De-Escalation in Senior Care
This article is very brief concerning de-escalation, its benefits, and how to use it. It is important for you to continue learning about it and become more skilled and confident in how you handle crises in health care settings. Don’t be like me when I was young and had no clue about what I was getting myself into. While ignorance is occasionally bliss, it can also get you hurt.
(NOTE: Interested in learning more about Behavioral and Mental Health? Checkout my Behavioral and Mental Health CEUs on CEU Academy and try a FREE CEU today!)