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Dealing with distressed clients

Dealing with distressed clients. And other fun stuff. When agitated behaviors occur:. Stay calm. Speak in a calm, neutral voice * Refrain from making judgmental statements about the situation or the person.*. Agitated behaviors can be very difficult.*

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Dealing with distressed clients

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  1. Dealing with distressed clients And other fun stuff

  2. When agitated behaviors occur: • Stay calm. Speak in a calm, neutral voice * • Refrain from making judgmental statements about the situation or the person.* • Agitated behaviors can be very difficult.* • Remember to look after yourself and take regular breaks. 

  3. De-escalating conflict… Don’t engage. You won’t win.* Let the person talk and listen.* Paraphrase * Empathize with them*.

  4. De-escalating conflict… • Tell that you want to help him/her • If the person is still angry and agitated calmly set a limit.* • Carry though with the promise. • If the person calms you can try to help him/her problem-solve. *

  5. The Why of it… • Confused • Scared • Overwhelmed • Sick/In pain • Cognitive impairment reduces one’s ability to be “socially appropriate”. • It’s not personal…it just feels that way. *

  6. This and that Tips • Use distraction when you can. • Use their name. • Even if the person is on the phone try to remember your non-verbal cues* • Periodically take slow (quiet) deep breaths. • Use physical tension relievers • Distance yourself some from their emotion* • Be your own cheerleader. * Tips

  7. Keep this stress kit near you. When all else fails…

  8. TELEPHONED SUICIDE THREATS • Keep calm • Follow posted protocol • Debrief afterward with a colleague or your manager

  9. Self Care

  10. Debrief and/or take a break

  11. Setting Boundaries • When you already know the person’s complaints/concerns , nothing has changed , & you can do nothing more. • Be Polite, but firm. • Set limits and enforce them. * • Ex. Mr. Smith, I’m sorry you’re upset. Nothing has changed since the last time we spoke. I will speak to you again on …. At…(suggest a time/date that makes sense). Goodbye.

  12. Clients who’ve Had A Stroke

  13. What’s Normal?* • Changes in mood, behavior and affect. • Not following social norms • Changes in sensitivity/tolerance • Changes in processing/reasoning Emotional Lability Social embarrassment; Communication issues* More frequent and more intense emotions Insight may be impaired which complicates this.

  14. What’s common Problem Outlook • Confusion * • Tiredness & Concentration problems. • Memory Problems. • May affect short-term memory (more common) or total memory. * • Cognitive problems after a stroke usually improve initially &then remain stable. • Tiredness & confusion usually improve with time & as you learn to adapt. • Depression can & may need to be treated*

  15. What’s Common Problem Strategy • Personality changes • Increased apathy • Irritability/impulsiveness • reasoning & problem solving/ judgment • Perceptual changes*, agnosia, getting lost, altered body image, apraxia, inattention • Patience and understanding are important to cope with this as a caregiver/family member or friend. • Avoid over reacting. It may feel personal but it isn’t really.

  16. The Why of it • Miscommunication in the brain between the cortex and sub-cortical area • Strokes often cause a neurologically based disorder of affective expression. • This results in involuntary emotional expression disorder (IEED), and difficulty regulating outward emotional expression. • “Emotional expression is uncontrolled and without an apparent triggers.”*

  17. What Helps • Redirect attention back to activity/conversation once the outburst settles • Distracting • Timing, tempo, tone • Encouraging slow, deep breaths • Giving specific instruction re behavior • Encouraging self-observation by the client

  18. LAST; BUT NOT LEAST! • Remember, Doing your best is ENOUGH!

  19. Distress Call http://www.youtube.com/watch?v=28IyWbLI0HA

  20. See it in action • http://www.dementiacarecentral.com/video/distress

  21. Case Studies

  22. Learning Activity • In your group review the article. • Highlight something helpful • Underline something you’ve done before. • Put a star beside something you might try.

  23. References (Alzheimer’s Australia) Agitated Behaviors. Retrieved March 12, 2013 from: http://www.fightdementia.org.au/services/agitated-behaviours.aspx (Alzheimer’s North Caroline Inc.) Dealing with Emotional Distress. Retrieved March 12, 2013 from: http://www.dementiacarecentral.com/video/distress (Ariel Waters). How to Calm and agitated person. Retrieved march 12, 2013 from: http://www.ehow.com/how_10010662_calm-agitated-person.html (image) Anti-stress Kit. Retrieved March 12, 2013 from: http://www.google.ca/imgres?q=stress+kit+image&um=1&hl=en&safe=active&sa=N&biw=1280&bih=603&tbm=isch&tbnid=jDkGp3LNr3JWIM:&imgrefurl=http://chen1923.blogspot.com/2009/11/anti-stress-kit.html&docid=chDGAT2eexfzmM&imgurl=http://3.bp.blogspot.com/_WjazDiGVblo/SwaEqMdSxkI/AAAAAAAAAaw/rBHPKa5zHT8/s1600/ANTISTRESS.jpg&w=1600&h=1131&ei=Uoo_UYHhGaaO0QG-j4B4&zoom=1&iact=rc&dur=312&page=1&tbnh=134&tbnw=175&start=0&ndsp=26&ved=1t:429,r:7,s:0,i:100&tx=82&ty=81 Caswell, Jon. May/June 2007 Stroke Connection. Living With Emotional Thunderstorms. Retrieved on May 3, 2013 from: http://www.nxtbook.com/nxtbooks/aha/strokeconnection_20070506/index.php#/20. Chest Heart and Stroke Scotland. Thinking and Behavior Issues After Stroke. Stroke Series SS9. Retrieved on May 3, 2013 from: http://www.chss.org.uk/publications/documents/Stroke/SS9 Thinking and behaviour issues.pdf

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