2/8/2011
1
The Mood Ring Theory
Understanding how mood can
influence behavior for folks
living with memory loss and
other special needs
Survey Says… Statistics suggest that
1. # of persons experiencing cognitive loss entering
our service over the next X years is around _____.
2. A high degree of persons with cognitive loss will
present with challenging behavior.
3. This will require a substantial increase in staff
trained and prepared to support persons with
challenging behavior.
4. Of the # move-out notices in RALF licensed
communities in the last year, about ____% are
related to challenging or unsafe behavior.
Setting the Stage
Synonymous with “Mood”
• Frame of Mind
• Disposition
• Status
Status can be reasonably predicted by
the set of behavioral symptoms
exhibited by the person at that time.
2/8/2011
2
Things that make you go
?HMMM?
For people who have compromised ability to
communicate, their behavior may be
1. The only way THEY have of telling us how they are
doing or what they need
and
1. The only indicator WE have of knowing how they
are or what they need
During our time together…
We will gain understanding of how:
• To identify behaviors associated with fluctuations in
a person’s mood or status.
• Adjusting our approach based on what we are
observing can prevent and/or decrease escalation.
• Individualized Person Centered Care can impact a
person’s well being on a daily basis (perhaps even
moment by moment basis) and the behavior that
comes out the other side.
Coming soon to a
classroom near you
“Toto, I don’t think we are in Woodstock
anymore”
Mantra for Functional Analysis of Behavior
• What do I not know?
• Get yourself informed.
• See it clearly.
2/8/2011
3
Quality of Life
Behavior
Quality of
Life
That by…
• Recognition of mood
fluctuations for a specific
person
AND
• Understanding what
might be influencing
them
AND
• Adjusting our support
and approach
accordingly
We will…
• Enhance quality of life.
• Reduce the # of incidents
of challenging behavior.
• Reduce the severity and
intensity of challenging
behavior.
• Improve our staff’s ability
to adjust their approach
based on their
observations.
I would like to suggest
Our Journey through History
How 70’s technology
has influenced
our 21st century thinking.
2/8/2011
4
From Then to Now
Behavior Modification/Management
• Techniques that influence behavior in a decided
direction.
Positive Behavior Support
• All behavior has meaning – It occurs for a reason.
Behavior is communication.
• Through careful analysis, we identify the meaning
and contributing factors .
• Make adjustments in service and support to address
factors identified in our analysis.
Behavioral Approach at a Glance
A B C
Antecedent Behavior Consequence
All behavior occurs in a sequence.
Antecedents
• Any noticeable event that happens
immediately before the behavior
occurs.
• Could also be called a cue or a trigger.
• Could also be called “the last straw.”
2/8/2011
5
Behavior (by definition)
• A response that happens after an
antecedent or cue.
• An observable and measurable action
that a person does to achieve what they
want or need in a particular situation.
A More Useful Definition
Behaviors are actions performed by a
person in an effort to meet their needs
or wants needs in a particular
circumstance.
Behavior is “what we do.”
Consequences (by definition)
• The result.
• What happens immediately after the
behavior occurs.
• What the person gets (or expects to
get) as a result of the behavior.
• What the person avoids (or hopes to
avoid) as a result of the behavior.
2/8/2011
6
Behavioral Voodoo in the 70’s.
A B C
Antecedent Behavior Consequence
• We addressed the consequences.
Pitfalls
• Didn’t address the cause of the behavior.
• Didn’t teach a new way to get needs met.
• Deals with the behavior “after” it occurs.
• All effort and time is spent in the reactive “portion of
the program.”
And… if we are going to spend the time addressing it
anyway, it makes sense to spend most of it on the
front end.
The next step in our journey
A B C
Antecedent Behavior Consequence
• We started evaluating antecedents.
• We started teaching new skills/new
ways for people to get their needs met.
• We continue to reinforce the positives.
2/8/2011
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Our next step in time…
SE A B C
Setting Events
• Identification of stressors and pre-sets.
• Taking measures to eliminate barriers.
• Adjustment of our supports and
approaches.
Status Status 1 – What does the person look like or
behave when they are “in a good mood” or
when things are going well.
Status 2 – What does the person look like or
behave when something is up, things aren’t
bad but not great.
Status 3 – What does it look like when the
person is not doing well at all or “in crisis.”
So… What’s next?
We now know how to IDENTIFY the
fluctuations in “status.”
What are we going to do about it?
2/8/2011
8
Status 1
Our Goal: To support them to maintain it.
1. Honor routines
2. Favorite activities
3. Favorite conversations
4. Must haves (non-negotiables)
Status 2
Our Goal: To address the need and
return to Status 1.
1. Evaluate possible reason(s)
2. Work to address those reason(s)
3. Adjust expectations/requests
Status 3
Our Goal(s): Assure safety, address
need and return to Status 1
1. Evaluate risk and respond accordingly
2. Avoid power struggles/reduce
requests
3. Evaluate possible reasons and
address
2/8/2011
9
Package it up!
• Service Planning
• Behavior Support Strategies
• Data Collection
Quality of Life
Behavior
Quality of
Life
Tips and Take-Aways
• Increase attention
• Proper introductions
• Train for understanding
– We are more alike than we are different
– 1 person rule
– ALL behavior has meaning
2/8/2011
10
Changing Minds PBS
www.changingmindspbs.com
www.atcbs.org
Laura Larson