Peter Case Study - Behaviour Of Concern - Conflict Management - George Yang - Health Report Writing Assessment Answer

Peter Case Study - Behaviour Of Concern - Conflict Management - George Yang - Health Report Writing Assessment Answer

Assessment Task:

This assessment will give you the opportunity to demonstrate your knowledge in the following areas:

• Observing and monitoring behaviour

• Verbal and non verbal strategies to ensure effective communication with individuals demonstrating behaviours of concern
• Identifying potential triggers and using strategies to defuse conflict situations
• Ensuring the safety of self and others
•  Managing conflict positively
• Using negotiation skills and communication techniques for effective interaction and problem solving

PART A:

Observing and Monitoring Behaviour of Concern

This case study relates to the role of you the Support Worker in observing, monitoring and evaluating the changed behaviours of clients so that strategies can be used to reduce risk to the client and to others. Read the case study below and respond to the questions following.

Case Study: Peter

You are working as a Support Worker in the community care division of CareShore, a large multi- service community based organisation that provides services to a wide range of adults requiring support in the community and in supported living accomodation.

A new client, Peter, has come to live in one of the houses where you work. There are 3 other residents living in the shared house, all of whom have a varying range and degree of disability. Peter is 59 years of age, has paraplegia and an acquired brain injury due to an accident.
Until recently, Peter has lived at home with his wife as his carer but she can no longer cope with his unpredictable aggressive verbal outburst and his highly agitated behaviour. Peter’s changed behaviours have been increasing in their unpredictability since his accident 10 years ago. At times
Peter feels very upset that he is not “the way he used to be” before the accident and he gets very sad.
Peter has cut himself when he threw his razor in frustration as he could not shave himself.
CareShore and the Support Worker team must accurately identify and assess Peter’s behaviour support needs so that his individual plan for care can be tailored and crafted to support him live the best possible lifestyle in his new home.

1. Referring to the case Study above, provide responses to the following questions. An example is provided to guide you.

a. Describe the potential conflicts that may arise as Peter moves into a shared home with people he may not have known in the past.

b. Knowing Peter has aggressive and unpredictable outbursts, what appropriate preventative and defusing strategies couldyou use to manage the situation. Give 2 examples of preventative strategies (in lines 1 & 2 right) and 2 examples of defusing strategies

c. Providing examples of formal and informal strategies, explain HOW you can observe and monitor Peter in a range of ways so as to get a clear and full understanding of his behavioural issues.

d. Briefly describe three (3) strategies you can use to ensure that your evaluation of Peter’s behaviour is consistent, fair and objective.

e. Briefly describe how the staff at CareShore can make sure their decisions and actions regarding Peter are consistent with the available evidence.

f. Briefly describe how the staff at CareShore can make sure their decisions and actions are consistent with CareShore’s own policies and prodcedures.

g. Describe what referrals you would suggest to provide additional support for Peter moving into the new home, and in relation to his feelings of sadness.

h. Describe what documentation and reporting you would undertake in relation to Peter cutting himself on his razor.

2. Answer the following questions in relation to your role as a Support Worker who is a member of a team providing behaviour support to individuals. Respond in the spaces provided. When supporting a client with changed behaviours, identify an example of each of the four (4) considerations you need to take into account before reacting to the particular situation.

3. Read the additional case study information below and respond to the questions following.

Case Study

After some time spent observing and monitoring Peter’s behaviour, it has become obvious that his outbursts can be very dramatic and there is a danger that he could injure himself as well as other clients and staff members.
He has punched holes in the wall and he has swung a chair at people on several occasions. It has proven very difficult to identify what “triggers” his behaviour as it does not seem to follow any recognisable pattern or situation.
His housemates have made comment that they are afraid of him. It is clear that there is an urgent need for Peter’s to receive support to manage his own behaviour so that he can live in a more positive manner

Part A. Research three (3) dedicated behaviour support professionals or organisations that CareShore could refer Peter to so as to get specialised supports.

PART B:
Manage Conflict Positively

1. Describe some of the legal and ethical considerations that must be taken into account by Support Staff when managing conflict (or potential conflict) in terms of:
- Client constraint
- Client imprisonment
- Client abuse

2. Outline some specific interpersonal and communication skills a support worker may use when managing conflict in order to successfully problem solve issues.

Case Study: George Yang
Read the case study below and respond to the questions following.

Case Study
George Yang lives at home with his daughter, Li and her family. CareShore support workers provide social and daily living support to Mr Yang three times a week. Recently, CareShore staff members have reported that there is an increasing amount of tension and argument in the evening between George and Li. The tension seems to arise from the clash between Li’s growing independence and the traditional conservative cultural values of George. This has worsened as Georges’ symptoms of Parkinson’s increase. The tension often happens when Li comes home from work and wants to tell her family about what happened in her day. At times, there can be very emotional conflicts between George and Li as their differences to life develop. George believes that Li should be staying home looking after him and her family.

3. Describe possible signs that could indicate there is an aggressive outburst about to unfold between George and Li.

4. What communication techniques can you use to manage and defuse conflict between George and his daughter? 

5. In managing conflict, such as that between George and Li, why do Support Workers need to consider cultural sensitivities, and how can they do this?

6. Describe how you can use relevant negotiation skills to examine the basis of the conflict(s) so that each party in the conflict can understand each other’s point of view, and respond differently.

PART C:

Respond to changed behaviours/behaviours of concern

1. When working with clients who have changed behaviours, what strategies can you use to encourage and outline opportunities to the client in order to support them to change their behaviour?

2. Identify four (4) strategies you could use if you found yourself in a situation where the individual is violent, aggressive and/or threatening to commit suicide.

Case Study: George Yang (continued)
Read the continuing case study of Mr Yang below and respond to the questions following.

Case Study
You are working as a support worker at the home of Mr George Yang for an early evening shift where you assist him to shower and go to bed. When you come on shift, you read the shift handover notes, and notice that the the day centre that George attends has sent home a communication book with a note that he seemed a little withdrawn during the activities and only ate half of his normal
lunch.

When you came on shift you also noticed that there is a very strained atmosphere in the house and it is clear that there has been some kind of argument or outburst between George and Li after she got home from work. In the course of the shift, Li tells you that George is a nastry old man and he does not appreciate living with the family, while George is sitting nearby and watching the news.

As you help George gather his toiletries for a shower, you ask him how his day was and he immediately starts yelling and calling out loudly that he is a burden to everyone, throwing things across the room and hitting his own head repeatedly with his closed fist. Li comes in and starts shouting at him to “stop” and to be “a good father”. The situation is escalating.

3. When responding to George’s behaviour, why do Support Workers need to use clear, calm and objective language?

4. What professional behaviours can you use when interacting with George and Li to model positive behaviour?

5. If Georges’ self-harm escalated and his head hitting was not abating, briefly describe how you would respond to this critical incident by:
- Naming one (1) defusing strategy.
- Naming one (1) way to ensure the safety of George, his family and yourself.
- Naming one (1) preventative strategy for the future.

6. When responding and/or intervening in Georges’ changed behaviours, why is it necessary for Support Workers to base their actions on:
a) Analysis of the situation
b) CareShore’s policies and guidelines?

PART D:

Complete reporting requirements

Case Study relating to Lauren, a new Support Worker at CareShore and you as her assigned buddy.

Read the case study below and respond to the questions following

Case Study

Lauren, 34, is a new entrant Support Worker at CareShore where you work and she has just completed her off-the-job induction training and has been assigned to you for a “buddy shift”. You have been selected for this role as a “buddy” because you have been working in your Support Worker role for the last 6 months and have experience of working with some individuals that CareShore support to remain living in their homes. You have experience of working with a particular resident – Peter (same Peter as in Case Studies A2 & A4 above). You meet up with Lauren at Peter’s shared home to begin the shift as required.

You introduce Lauren to Peter and explain to Peter that Lauren is a new worker and that she is being introduced to the residents of the house and getting an insight into the daily support routine. Peter says that he would be happy to help with Lauren’s induction to working in the home and explain to her “how things work”.

During the shift, one of the other residents comes home from work early and you notice that Peter immediately seems to get agitated and tells the other resident to go to his room as he is “training” Lauren. The other resident, Joe, says he does not want to go to his room and is keen to meet Lauren if she is going to be working at the house.

Joe’s comment triggers a critical incident where Peter starts ramming his powered wheelchair at Joe and yelling very abusively at him. He also tries to hit Joe and you ask Lauren to stand back and observe as you use the intervention strategies that have been developed as part of Peter’s Behaviour Support/Management Plan.

The interventions work, the situation subsides and you remind Lauren that it is necessary for a critical incident report to be completed and forwarded to the CareShore manager in charge of supervising this shared home and others in the region. This is a great opportunity for you to support Lauren to complete a real incident report correctly according to CareShore’s requirements.

1. When explaining the reporting process to Lauren, what CareShore policies and procedures and what Legislation would you refer to as being the guiding principles for how reporting is to be done?

2. Explain what you would do if, while supporting Lauren to complete the Critical Incident Report, you noticed that the form does not really capture all of the information that would be usually be needed for the Manager to evaluate and manage the report.

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